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Abstract: SA-PO240

Prevalence and Risk Factors of CKD Anemia in the United States

Session Information

Category: Anemia and Iron Metabolism

  • 202 Anemia and Iron Metabolism: Clinical

Authors

  • Davis, Jill, Astrazeneca, Wilmington, Delaware, United States
  • Caspard, Herve, AstraZeneca, Gaithersburg, Maryland, United States
  • Little, Dustin J., AstraZeneca, Gaithersburg, Maryland, United States
  • Perkins, Robert M., Astrazeneca, Wilmington, Delaware, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
Background

The most recent estimate to date of the prevalence of anemia in patients with chronic kidney disease (CKD) in the US is supported by data from US National Health and Nutrition Examination Survey (NHANES) in 2007-2010. We analyzed the NHANES database from 1999 to 2016 to update the prevalence of anemia among the US adult population with CKD and investigate risk factors.

Methods

CKD stage was assessed using the estimated glomerular filtration rate (eGFR) derived from serum creatinine using CKD-EPI equation. Anemia was defined as hemoglobin ≤13 g/dL in men and ≤12 g/dL in women, and severe anemia as hemoglobin (Hb) <10 g/dL (per KDIGO guidelines). Pregnant women were excluded. NHANES participants who had received dialysis treatment in the 12 months before the survey were considered as presenting CKD stage 5 but were excluded for estimation of prevalence of anemia. Associations between anemia and CKD stage, age, sex, race/ethnicity, smoking status, diabetes, hypertension, and body mass index were investigated. A logistic regression multivariate model was fit using a stepwise downward approach.

Results

Median age (yrs) of all the NHANES participants with CKD was 73.4 (interquartile range: 64.2-79.3); 59.4% (95% CI: 57.7-61.1) were female; 9.8% (95% CI: 8.4-11.1) were African-American; and 25.1% (95% CI: 23.3-26.8) reported diabetes mellitus. Prevalence estimates of anemia and severe anemia in 2015-2016 were 23.5% (95% CI: 19.4-27.7) and 1.2% (95% CI: 0.4-2.0), respectively. Association between CKD stage and anemia and severe anemia is shown in the Table.

Conclusion

Only a small fraction of CKD patients with anemia present with Hb <10 g/dL and are eligible for treatment. The risk of anemia and severe anemia is markedly increased in patients with lower eGFR.

Funding

  • Commercial Support – AstraZeneca