Prevalence and management of anemia in pre-dialysis Malaysian patients: A hospital-based study

Abstract

Summary Objective: Anemia, a common complication of chronic kidney diseases (CKD), is involved in significant cardiovascular morbidity. Therefore, the objective of our study was to investigate the prevalence and severity of anemia in pre-dialysis patients, as well as to determine the predictors of anti-anemic therapy. Method: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013. Results: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD. Conclusion: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.

Prevalence of Anemia and its Association with Kidney Function in Pre- Dialysis CKD Patients in Nepal: A Cross-Sectional Study

“…As far as severity of anemia concerned, majority of the patients in this study was mild anemia followed by severe anemia. However, the prevalence of severity of anemia in this study was inconsistent with earlier: Salman [21] reported that most of the pateints had mild followed by moderate, whereas Reza et al showed that most of the predialysis patients had moderate anemia followed by mild anemia [26]. We observed that the percentage of severe anemia in the last stage of CKD significantly increased, reflecting that the prevalence of anemia increase with declining renal function.…”

“…The available literatures indicate a wide variation in prevalence of anemia in CKD patients across the nation. In this study anemia was estimated to be present in 53.57% in any stage of CKD, and the result is somewhat lower than the previous study, 58.5% by Aleix Cases-Amenos [4] and 75.8% by Salman M et al [21]. Similarly, a higher prevalence of anemia (64.9%; defined as hemoglobin 13 g/dL for men, and 12 g/dL for women) was observed in US nursing home residents aged 64 with CKD stages 3-5 [22].…”

Association between Severe Anemia and Outcomes of Hemodialysis Vascular Access

“…Most HD accesses were created as outpatient procedure (84%) with median of zero days for total length of stay (LOS). However, patients with severe anemia undergoing access creation as inpatient had significantly higher median LOS compared with moderate and normal/mild anemia (9 [5,16] (Fig. 1).…”

Clinical characteristics of anemia in chronic kidney disease of patients of the National Hospital in 2018

“…La anemia de estos pacientes se correlacionó con la declinación del clearance de creatinina. La anemia fue normocítica normocrómica en 77%, microcítica (23) hipocrómica en 22% y macrocítica en 1%. No se determinaron las reservas de hierro .…”