Prevalence of Anemia According to Stage of Chronic Kidney Disease in a Large Screening Cohort of Japanese

Overview

Journal Clin Exp Nephrol

Publisher Springer

Specialty Nephrology

Date 2009 Jun 16

PMID 19526304

Citations 10

Authors

Kentaro Kohagura

Nozomi Tomiyama

Kozen Kinjo

Shuichi Takishita

Kunitoshi Iseki

Affiliations

Soon will be listed here.

Abstract

Background: The prevalence of chronic kidney disease (CKD) is high in developed countries, including Japan. However, little is known about the prevalence of anemia according to the estimated glomerular filtration rate (eGFR) among Japanese.

Methods: We studied screenees on the Okinawa General Health Maintenance Association (OGHMA) registry in 1993 (N = 94,602; 54,848 women and 39,754 men) who had both serum creatinine and hematocrit data. Anemia was defined as follows: hematocrit level <40% in men, <32% in women aged <50 years, and <35% in women aged >or=50 years. GFR was estimated using a new Japanese equation: eGFR (ml/min per 1.73 m(2)) = 194 x serum creatinine(1.094) x age(0.287) x 0.739 (if female).

Results: The prevalence of anemia clearly increased as CKD progressed below an eGFR of 60 ml/min per 1.73 m(2) in both genders. Logistic analysis adjusted with body mass index and older age (>or=70 years) revealed that the odds ratio for complications of anemia was significantly increased below an eGFR of 45 ml/min per 1.73 m(2) in women and 90 ml/min per 1.73 m(2) in men. The association of lower kidney function with anemia was found to be more prevalent: adjusted odds ratio >or=2.0, from approximately 50 ml/min per 1.73 m(2).

Conclusion: The present study suggested that there might be as many as 1,000,000 people with CKD stage 3-5 complicated with anemia in Japan.

Citing Articles

Prevalence of anemia and associated All-Cause mortality among adults with Diabetes: The role of chronic kidney disease.

Koyama A, Lundeen E, Bullard K, Pavkov M Diabetes Res Clin Pract. 2023; 200:110695.

PMID: 37156427 PMC: 10701781. DOI: 10.1016/j.diabres.2023.110695.

Estimating the causal effect of transient anemia status on renal and cardiovascular outcomes in community-dwelling patients in Japan at the beginning of impaired renal function using marginal structural modeling.

Onozawa S, Kimura T, Ito Y, Akizawa T Clin Exp Nephrol. 2021; 26(2):178-189.

PMID: 34596791 PMC: 8770383. DOI: 10.1007/s10157-021-02137-1.

Molidustat for the treatment of anemia in Japanese patients undergoing peritoneal dialysis: a single-arm, open-label, phase 3 study.

Akizawa T, Nobori K, Matsuda Y, Taki K, Hayashi Y, Hayasaki T Ther Apher Dial. 2021; 26(2):368-377.

PMID: 34310049 PMC: 9290504. DOI: 10.1111/1744-9987.13713.

Vadadustat for anemia in chronic kidney disease patients on peritoneal dialysis: A phase 3 open-label study in Japan.

Nangaku M, Kondo K, Takabe S, Ueta K, Kaneko G, Otsuka M Ther Apher Dial. 2020; 25(5):642-653.

PMID: 33283981 PMC: 8451920. DOI: 10.1111/1744-9987.13611.

Risk of Anemia in Patients with Newly Identified Chronic Kidney Disease - A Population-Based Cohort Study.

Vestergaard S, Heide-Jorgensen U, van Haalen H, James G, Hedman K, Birn H Clin Epidemiol. 2020; 12:953-962.

PMID: 32982460 PMC: 7494011. DOI: 10.2147/CLEP.S259648.

References

Fehr T, Ammann P, Garzoni D, Korte W, Fierz W, Rickli H . Interpretation of erythropoietin levels in patients with various degrees of renal insufficiency and anemia. Kidney Int. 2004; 66(3):1206-11. DOI: 10.1111/j.1523-1755.2004.00880.x. View

Singh A, Szczech L, Tang K, Barnhart H, Sapp S, Wolfson M . Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med. 2006; 355(20):2085-98. DOI: 10.1056/NEJMoa065485. View

Go A, Chertow G, Fan D, McCulloch C, Hsu C . Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004; 351(13):1296-305. DOI: 10.1056/NEJMoa041031. View

Muntner P, He J, Astor B, Folsom A, Coresh J . Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease: results from the atherosclerosis risk in communities study. J Am Soc Nephrol. 2004; 16(2):529-38. DOI: 10.1681/ASN.2004080656. View

Hsu C, Bates D, Kuperman G, Curhan G . Relationship between hematocrit and renal function in men and women. Kidney Int. 2001; 59(2):725-31. DOI: 10.1046/j.1523-1755.2001.059002725.x. View

Coresh J, Byrd-Holt D, Astor B, Briggs J, Eggers P, Lacher D . Chronic kidney disease awareness, prevalence, and trends among U.S. adults, 1999 to 2000. J Am Soc Nephrol. 2004; 16(1):180-8. DOI: 10.1681/ASN.2004070539. View

Gejyo F, Saito A, Akizawa T, Akiba T, Sakai T, Suzuki M . 2004 Japanese Society for Dialysis Therapy guidelines for renal anemia in chronic hemodialysis patients. Ther Apher Dial. 2005; 8(6):443-59. DOI: 10.1111/j.1774-9987.2004.00199.x. View

Phrommintikul A, Haas S, Elsik M, Krum H . Mortality and target haemoglobin concentrations in anaemic patients with chronic kidney disease treated with erythropoietin: a meta-analysis. Lancet. 2007; 369(9559):381-8. DOI: 10.1016/S0140-6736(07)60194-9. View

Abramson J, Jurkovitz C, Vaccarino V, Weintraub W, McClellan W . Chronic kidney disease, anemia, and incident stroke in a middle-aged, community-based population: the ARIC Study. Kidney Int. 2003; 64(2):610-5. DOI: 10.1046/j.1523-1755.2003.00109.x. View

10.

. NKF-DOQI clinical practice guidelines for the treatment of anemia of chronic renal failure. National Kidney Foundation-Dialysis Outcomes Quality Initiative. Am J Kidney Dis. 1997; 30(4 Suppl 3):S192-240. View

11.

Silverberg D, Wexler D, Blum M, Schwartz D, Wollman Y, Iaina A . Erythropoietin should be part of congestive heart failure management. Kidney Int Suppl. 2003; (87):S40-7. DOI: 10.1046/j.1523-1755.64.s87.7.x. View

12.

Hsu C, McCulloch C, Curhan G . Epidemiology of anemia associated with chronic renal insufficiency among adults in the United States: results from the Third National Health and Nutrition Examination Survey. J Am Soc Nephrol. 2002; 13(2):504-510. DOI: 10.1681/ASN.V132504. View

13.

Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K . Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009; 53(6):982-92. DOI: 10.1053/j.ajkd.2008.12.034. View

14.

Chaves P, Ashar B, Guralnik J, Fried L . Looking at the relationship between hemoglobin concentration and prevalent mobility difficulty in older women. Should the criteria currently used to define anemia in older people be reevaluated?. J Am Geriatr Soc. 2002; 50(7):1257-64. DOI: 10.1046/j.1532-5415.2002.50313.x. View

15.

Sarnak M, Levey A, Schoolwerth A, Coresh J, Culleton B, Hamm L . Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and.... Circulation. 2003; 108(17):2154-69. DOI: 10.1161/01.CIR.0000095676.90936.80. View

16.

Coresh J, Astor B, Greene T, Eknoyan G, Levey A . Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis. 2002; 41(1):1-12. DOI: 10.1053/ajkd.2003.50007. View

17.

Silverberg D, Wexler D, Blum M, Wollman Y, Iaina A . The cardio-renal anaemia syndrome: does it exist?. Nephrol Dial Transplant. 2003; 18 Suppl 8:viii7-12. DOI: 10.1093/ndt/gfg1084. View

18.

Brockenbrough A, Dittrich M, Page S, Smith T, Stivelman J, Bremner W . Transdermal androgen therapy to augment EPO in the treatment of anemia of chronic renal disease. Am J Kidney Dis. 2006; 47(2):251-62. DOI: 10.1053/j.ajkd.2005.10.022. View

19.

Astor B, Muntner P, Levin A, Eustace J, Coresh J . Association of kidney function with anemia: the Third National Health and Nutrition Examination Survey (1988-1994). Arch Intern Med. 2002; 162(12):1401-8. DOI: 10.1001/archinte.162.12.1401. View

20.

Iseki K, Kinjo K, Iseki C, Takishita S . Relationship between predicted creatinine clearance and proteinuria and the risk of developing ESRD in Okinawa, Japan. Am J Kidney Dis. 2004; 44(5):806-14. View