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Study: Severe Anemia Common in CKD Patients

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WASHINGTON—Researchers
who studied a cohort of patients with non-dialysis-dependent chronic kidney
disease (CKD) found that nearly one-quarter of them had severe anemia,
according to a presentation at the American Society of Nephrology’s Kidney Week
2019 meeting.

At baseline,
out of 22,720 patients with CKD stages 3a to 5, 5283 (23.3%) had severe anemia,
defined as a hemoglobin level below 10 g/dL and making patients eligible for
treatment, Eric T. Wittbrodt, PharmD, MPH, of AstraZeneca in Gaithersburg,
Maryland, and colleagues reported in a poster presentation. The inpatient and
outpatient prevalence of anemia was 32.6% and 21.2%, respectively. Among
patients without anemia at baseline, the incidence rate for developing anemia
over 5 years was 8.92 per 100 person-years.

Results
showed that anemia persistence overall—defined as uninterrupted hemoglobin
levels below 10 g/dL—was substantial and greater than anemia recurrence during
follow-up, according to the investigators. For the overall study population,
the incidence rates for anemia persistence and recurrence were 3.17 and 0.89
per 100 person-years, respectively. Among the patients with anemia at baseline,
rates were 10.83 and 2.13 per 100 person-years, respectively. For the 17,437
patients without anemia at baseline, the rates were 1.59 and 0.29 per 100
person-years, respectively.

Dr
Wittbrodt’s team analyzed data from a large US electronic medical record
database linked to to insurance claims. The study population had a mean age of
70.4 years and mean follow-up period of 3.36 years. Of the 22,720 patients, 63.9%,
24.9%, 8.5%, and 2.7% had CKD stage 3, 3a, 4, and 5, respectively.

In a
separate study of 2007-2010 data from the National Health and Nutrition
Examination Survey (NHANES) presented at the conference, Jill Davis, MS, of
AstraZeneca in Wilmington, Delaware, and colleagues found that the US
prevalence of anemia among adults—defined as a hemoglobin level of 13 g/dL or
less for men and 12 g/dL or less for women—was 23.5%. The prevalence of severe
anemia (hemoglobin level below 10 g/dL) was 1.2%.

According to Dr Wittbrodt, the main reason for the disparity in prevalence of severe anemia between his study and the one by Davis and colleagues was that his study looked at period prevalence (hemoglobin level less than 10 g/dL at any point in time 6 months before and after the index date), whereas the NHANES analysis used point prevalence (ie, hemoglobin level below 10 g/dL at one point in time). Also, the current analysis included hemoglobin levels from both inpatients and outpatients.

Reference

Wittbrodt
ET, James G, Kumar SR et al. Prevalence of CKD anemia in non-dialysis-dependent
patients using linked US claims and electronic health record data. Presented at
the American Society of Nephrology’s Kidney Week 2019 meeting held November 5
to 10 in Washington, DC. Poster SA-PO242.

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