Prevalence, awareness, and treatment of anemia in Chinese patients with nondialysis chronic kidney disease

Abstract

This was the first multicenter, cross-sectional survey to assess the prevalence of anemia, patient awareness, and treatment status in China. Data of patients with chronic kidney disease (CKD; age, 18–75 years; both out- and inpatients) from 25 hospitals in Shanghai, seeking medical treatment at the nephrology department, were collected between July 1, 2012 and August 31, 2012. The prevalence, awareness, and treatment of anemia in patients with nondialysis CKD (ND-CKD) were assessed. Anemia was defined as serum hemoglobin (Hb) levels ≤12 g/dL in women and ≤13 g/dL in men. A total of 2420 patients with ND-CKD were included. Anemia was established in 1246 (51.5%) patients: 639 (51.3%) men and 607 (48.7%) women. The prevalence of anemia increased with advancing CKD stage (χ2trend = 675.14, P < 0.001). Anemia was more prevalent in patients with diabetic nephropathy (68.0%) than in patients with hypertensive renal damage (56.6%) or chronic glomerulonephritis (46.1%, both P < 0.001). Only 39.8% of the anemic patients received treatment with erythropoietin and 27.1% patients received iron products; furthermore, 22.7% of the patients started receiving treatment when their Hb level reached 7 g/dL. The target-achieving rate (Hb at 11–12 g/dL) was only 8.2%. Of the 1246 anemia patients, only 7.5% received more effective and recommended intravenous supplementation. Anemia is highly prevalent in patients with ND-CKD in China, with a low target-achieving rate and poor treatment patterns. The study highlights the need to improve multiple aspects of CKD management to delay the progression of renal failure.

Anemia prevalence and its impact on health‐related quality of life in Indian diabetic kidney disease patients: Evidence from a cross‐sectional study

“…A similar effect was observed in large‐scale, cross‐sectional, US multicenter survey, where the prevalence was found to be increased with the decline in renal function . Evidence from Chinese cross‐sectional study also reported the similar observation, the prevalence of anemia increased from 22.4 to 79.2% from stage‐I CKD to Stage‐IV CKD . Likewise, Loutradis conducted a nested case‐control study and found a higher prevalence of anemia in T2DM CKD patients with advanced CKD stages .…”

“…The reason for the higher prevalence could be the older age of the participants as age is the risk factor for the development of anemia . A multicentre cross‐sectional study from Barcelona and China also reported a high prevalence of anemia (58.5 and 51.5%) in patients with nondialysis CKD . Studies from Korea (44.9%), Cameroon (41.4%), Iran (30%), and United States (15.4%) reported a lower prevalence of anemia person with diabetes with altered kidney function .…”

The Prevalence and Management of Anemia in Chronic Kidney Disease Patients: Result from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD)

“…The similar Chinese cohort including 2,420 CKD stage 1–5 patients aged 18–75 reported that 51.5% of patients had anemia (9). A Japanese cohort study showed that 32.3% of 2,930 patients with CKD stage 3–5 were diagnosed as anemia (16).…”

“…Until now, there have been no studies suggesting the target ferritin level in patients with CKD stage 1–2. We used the cutoff value of ferritin at 100 ng/mL and TSAT at 20.0% in accordance with similar studies including patients with CKD stage 1–5 (925). Among patients with anemia, 44.3% had TSAT more than 20.0% and ferritin more than 100 ng/mL in this study.…”

“…The recent NHANES report showed that the prevalence of anemia was 15.4% in CKD stage 1–5 patients compared with 7.5% in non-CKD population (8). A Chinese report showed that 51.5% of patients with CKD stage 1–5 had anemia (9). There were limited data about prevalence of anemia in CKD patients in Korea.…”