Prevalence of anemia in predialysis chronic kidney disease: Is the study center a significant factor?

• Published in: PloS one 2020-04, Vol.15 (4), p.e0230980-e0230980
• Main Authors: Alagoz, Selma, Dincer, Mevlut Tamer, Eren, Necmi, Bakir, Alev, Pekpak, Meltem, Trabulus, Sinan, Seyahi, Nurhan
• Format: Article
• Language: English
• Subjects: Aged; Analysis; Anemia; Anemia - epidemiology; Anemia - etiology; Bias; Biology and Life Sciences; Blood diseases; Care and treatment; Chronic kidney failure; Cohort Studies; Cross-Sectional Studies; Diabetes; Dialysis; Diseases; Epidermal growth factor receptors; Female; Ferritin; Ferritins - metabolism; Gender; Glomerular filtration rate; Glomerular Filtration Rate - physiology; Glycosylated hemoglobin; Health risks; Health services; Hematology; Hemoglobin; Hemoglobins; Hemoglobins - metabolism; Humans; Iron; Iron - metabolism; Kidney diseases; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - metabolism; Kidneys; Laboratories; Male; Management; Medical records; Medical research; Medicine and Health Sciences; Middle Aged; Mortality; Nephrology; Nephrology - methods; Patients; Physical Sciences; Prevalence; Prevalence studies (Epidemiology); Regression analysis; Renal Dialysis - adverse effects; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - metabolism; Research and Analysis Methods; Risk analysis; Risk Factors; Standard data; Statistical analysis; Studies; Values; Vitamin B
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0230980

Anemia is highly prevalent in chronic kidney disease patients; however, its identification and management have been reported to be suboptimal. In this study we aimed to describe the prevalence, severity, risk factors, and treatment of anemia in different nephrology centers, among chronic kidney disease patients who were not given renal replacement therapy. We performed a multicenter cross-sectional study in three different nephrology clinics. Adult (>18 years of age) chronic kidney disease patients with an estimated glomerular filtration rate (eGFR) below 60 ml/min, and who were not started dialysis were recruited. Demographic, clinical and laboratory data regarding anemia and its management were collected using a standard data form. Anemia was defined as a hemoglobin level below 12g/dL and severe anemia as a hemoglobin level below 10g/dl. A total of 1066 patients were enrolled in the study. Anemia and severe anemia were present in 55.9% and 14.9% of the patients, respectively. The mean hemoglobin level for the whole cohort was 11.8±1.8 g/dL. Univariate analyses revealed that the mean hemoglobin level was significantly different among the centers. Moreover, the frequency of the presence of anemia stratified by severity was also significantly different among the centers. According to binary logistic regression analysis, gender, levels of eGFR and iron, ferritin ≥ 100 ng/mL, and the nephrology center were independent determinants of severe anemia. We found a high prevalence of anemia among chronic kidney disease patients who were not on renal replacement therapy. Each center should determine the treatment strategy according to the patient's characteristics. According to our results, the center-specific management of anemia seems to be important.