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Abstract: TH-PO711

Racial Disparity in Anemia of CKD in the Adult US Population: Results From NHANES 1999-2018

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health


  • Singh, Ajay K., Harvard Medical School, Boston, Massachusetts, United States
  • Farag, Youssef MK, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States

Racial disparities have been reported in the U.S for many aspects of clinical care, including in CKD. Evaluation of anemia in CKD patients in a representative population in the United States has not been examined.


We analyzed data from NHANES 1999 to 2018 which included 101,316 participants. eGFR was calculated using the race-free CKD-EPI 2021 equation. CKD was defined and staged based on KDIGO guidelines. Anemia was defined using WHO criteria. Appropriate sample weights were used to account for the complex survey design. To test the association between race and anemia, we used multiple logistic regression adjusting for demographics and clinical variables.


The weighted period prevalence of CKD in adult US population was 14.1%, of whom 14.6% were anemic, 1.35% and 0.55% had hemoglobin <10g/dL and 9g/dL, respectively, and increased over the 20-year period. Non-Hispanic Blacks had consistently higher prevalence of anemia of CKD compared to other races, and such prevalence increased over time. Fig 1 shows prevalence of anemia by race and CKD stage. Marked disparity was observed among non-Hispanic Blacks, with significantly higher prevalence of anemia compared to non-Hispanic Whites at each stage of CKD (p<0.001). Non-Hispanic Blacks had 3.6-fold higher odds of being anemic compared to non-Hispanic Whites (adjusted OR 3.6, 95% CI, 3.0, 4.3, p<0.001).


A racial disparity exists with CKD anemia in non-Hispanic Blacks in the US population. While NHANES data may have some limitations, these findings raise public health concerns that suggest gaps in CKD care disadvantaging Black’s with CKD in the US.