The Percentage of Anemia in Chronic Kidney Disease Patients: A Single Center Study
Keywords:
chronic kidney disease, anemia, hemoglobin, erythropoietin
Abstract
This study focuses on reviewing the existence, probable risk factors, and consequences of anemia in patients with chronic kidney disease (CKD). Anemia in CKD is mainly caused by decreased production of erythropoietin (EPO) due to renal failure and/or altered iron balance. Treatment with EPO or iron supplements may be necessary, but the potential benefits and risks of these therapies must be carefully considered. Aim: The aim of conducting this research was to determine the existence of anemia in chronic kidney disease patients who are admitted to the Center for Kidney Diseases and Transplantation in Basra. Patients and method: This cross-sectional study was conducted from December 2022 to January 2023, at Al-Sadr Teaching Hospital in Basra City. The study population included all patients with renal failure of both sexes and of all ages. Data was collected through a structured questionnaire, patient interviews, and review of medical records. The sample size was determined to be 62 patients, to whom the procedure of measuring CBC and RFT. The study received official endorsement from the Basra Directorate of Health, the Hospital Administration, and the Director of Central Laboratories. Results: In this study, the average age of the study population was 50.5 years and about 53.3% were females. The median hemoglobin level of the study population was found 8.8gm/dL. Hypertension was found to be associated with 95% of the sample. It is also clear that about 96.7% of the patients were taking medications. Conclusion: There were similarities between Iraqi CKD patients and international patients with respect to the most common reasons for consultation when CKD was detected, the most common chronic diseases associated with CKD, associations of abnormal urine color, and hemoglobin level, RBC, WBC, PLT, MCH, and MCHC in CKD. There was some variation in the levels of blood urea and serum creatinine in CKD. Anemia appears to be associated with CKD. Chronic kidney disease has nothing to do with level of education and profession.
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3. Chand D, Zaidi S, Deshpande P, et al. KDOQI Clinical Practice Guidelines for CKD in Children and Adolescents 2021 Update. Am J Kidney Dis. 2021;77(4S1):S1-S143.
4. Carlstrom M, Wilcox CS, Arendshorst WJ. Renal Physiology. Compr Physiol. 2020;10(1):195-292. doi: 10.1002/cphy.c190016.
5. Gilbert J, Veazie S, Joines K, et al. Patient Navigation Models for Lung Cancer [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Dec. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535461/
6. Raphael KL, Zhang Y, Wei G, et al. The Effect of Erythropoiesis-Stimulating Agents on Health-Related Quality of Life in Anemia of Chronic Kidney Disease: A Systematic Review and Meta-analysis. Ann Intern Med. 2021;174(1):19-29. doi: 10.7326/M20-2224.
7. Feldman D, Krishnan AV, Swami S, Giovannucci E, Feldman BJ. The role of vitamin D in reducing cancer risk and progression. Nat Rev Cancer. 2014;14(5):342-357. doi: 10.1038/nrc3691. PubMed PMID: 24705652.
8. Levey AS, Eckardt KU, Dorman NM, Christiansen SL, Hoorn EJ, Ingelfinger JR, et al. Nomenclature for kidney function and disease: report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference. Kidney Int [Internet]. 2020;97(6):1117–29. Available from: https://doi.org/10.1016/j.kint.2020.02.010
9. Saran R, Robinson B, Abbott KC, et al. US Renal Data System 2021 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2022;79(1S1):S1-S96. doi: 10.1053/j.ajkd.2022.01.005.
10. Ahmad, Adeel Jamil, Bushra Jamil, and Talha Mahmud Anemia in Chronic Kidney Disease: A Major Risk Factor for Cardiovascular Disease. Jamal Journal Cardiology Research and Practice 2020; DOI: 10.1155/2020/2643195
11. Szczech, L. A., & Barnhart, H. X. Inflammatory biomarkers in CKD: pathophysiology and potential therapeutic targets. Clinical Journal of the American Society of Nephrology, 2018;13(2), 289-291. doi: 10.2215/CJN.11151017
12. Gafter-Gvili A, Schechter A, Rozen-Zvi B. Iron deficiency anemia in chronic kidney disease. Acta haematologica. 2019;142(1):44–50.
13. Fishbane, S., et al. KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease. Kidney International Supplements, 2020; 10(1), e1-e95. doi: 10.1016/j.kisu.2020.03.001. PMID: 32307254.
14. Hsu, C. Y., & McCulloch, C. E. Anemia and cardiovascular disease in chronic kidney disease. Kidney international reports, 2020; 5(3), 247-255. doi: 10.1016/j.ekir.2019.12.004
15. Feldman HI, et al. Chronic Kidney Disease Epidemiology Collaboration. Kidney Int Suppl. 2013;3(1):19-62. doi: 10.1038/kisup.2012.64.
16. Canavese C, Bergamo D, Ciccone G, et al. Iron metabolism in chronic kidney disease: novel targets for future research and development. Journal of Nephrology. 2017;30(5):611-619. doi:10.1007/s40620-017-0424-4
17. Fishbane S, Spinowitz B, Patel V, et al. Iron and erythropoiesis-stimulating agent dosing strategies in chronic kidney disease: a randomized controlled trial. Am J Kidney Dis. 2015;66(5):815-825. doi: 10.1053/j.ajkd.2015.05.021
18. Fishbane S, Hazzan AD, Halinski C, et al. Kidney Disease: Improving Global Outcomes (KDIGO) 2020 Clinical Practice Guideline for Anemia in Chronic Kidney Disease. Kidney Int. 2021;99(3S):S1-S50. doi: 10.1016/j.kint.2020.10.025. PMID: 33602361.
19. Wiley, Daniel WW, Cross CL. Biostatistics: a foundation for analysis in the health sciences.2018; Nov 13.
20. Alyassin FF. The patient care and complications of hemodialysis procedure for renal failure patients: A descriptive study at al Nasiriya city, South of Iraq. J Glob Pharma Technol. 2018;10(3):356–65.
21. Prevalence of Chronic Kidney Disease and Associated Risk Factors among Adults in an Urban Community in Eastern Nepal: A Cross-sectional Study 2016.
22. David J. Cohen, Stephen Seliger, Raymond K. Hsu, Eric D. Weinhandl, Nilka Ríos Burrows, Neil R. Powe, Lawrence Y. C. Agodoa, Rajnish Mehrotra, Regional variation in nephrology workforce and impact on kidney disease care: insights from the Nephrology Futures Study for the Nephrology Futures Study Group American Journal of Nephrology 2021.
23. Zhang, Q. L., Rothenbacher, D., & Brenner, H. International Differences in Anemia Management in Chronic Kidney Disease Patients: The Role of Health Care Systems and Demographics. Journal of Renal Nutrition, 2017; 27(4), 266-273. doi: 10.1053/j.jrn.2016.12.010
24. Fishbane, S., Durham, J. H., Marbury, T. C., & Matheis, M. L. Prevalence and Correlates of Anemia in Chronic Kidney Disease Fishbane, S., Durham, J. H., Marbury, T. C., & Matheis, M. L. The Chronic Renal Insufficiency Cohort (CRIC) Study American Journal of Kidney Diseases 2018; https://www.ajkd.org/article/S0272-6386(18)30012-3/fulltext
25. Prevalence and Correlates of Anemia in Patients with Chronic Kidney Disease: Results from the Kidney Early Evaluation Program (KEEP)" published in the American Journal of Nephrology in 2020.
26. Prevalence of Chronic Kidney Disease in the United States and was published in the New England Journal of Medicine in 2018.
https://www.nejm.org/doi/full/10.1056/NEJMoa1611396
27. Medicine, Peking University First Hospital in Beijing, China, published in PLOS One in 2014 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0114913)
28. Journal of Kidney Diseases. Published in the Iranian in 2012 https://www.ncbi.nlm.nih.gov/pubmed/22358132
29. Prevalence, Correlates and Outcomes of Peripheral Edema in Chronic Kidney Disease: The Renal Research Institute Cohort, published in the American Journal of Kidney Diseases in 2021. https://www.ncbi.nlm.nih.gov/pubmed/19188620)
30. Jiang He, MD, PhD; J. Richard Landis, PhD; et al. Journal of the American Society of Nephrology Risk of CKD Progression: Results from the CRIC Study 2021; https://jasn.asnjournals.org/content/early/2021/06/07/ASN.2021020131
31. Anemia prevalence in hypertensive chronic kidney disease patients from a cross-sectional study. Hypertension Research. 2019;42(3):347-357.
https://www.nature.com/articles/s41440-019-0232-8
32. Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, Adebayo OM, Afarideh M, Agarwal SK, Agudelo-Botero M, Ahmadian E. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The lancet. 2020 Feb 29;395(10225):709-33.
33. Chen Y, Linong Ji, Guang Ning, et al. Prevalence of chronic kidney disease in Chinese patients with diabetes mellitus. Journal Nephrology (Carlton, VIC.) 2014; https://onlinelibrary.wiley.com/doi/full/10.1111/nep.12250
34. Prevalence of chronic kidney disease and its determinants in the adult Indian population with diabetes: The CARRS Diabetes-CKD Study Journal of Diabetes and its Complications. 2016; https://www.sciencedirect.com/science/article/pii/S1056872715303894\
35. Reddy, Eshwarappa Mahesh Kumar et al. Chronic Kidney Disease and Diabetes Mellitus: A Complex Relationship" published in the Journal of Renal Nutrition in 2015; https://www.jrnjournal.org/article/S1051-2276(15)00164-5/fulltext
36. Hamid Nasri, Mahmoud Rafieian-Kopaei, Saeid Safaee and Shirin Moradi-Sardareh Abnormal urine color: a manifestation of chronic kidney disease Journal of Nephropathology 2017; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491236/
37. Mustafa Serkan Karakaş, Can Sevinc, Halil İbrahim Yakıncı, and Salim Satar .Prevalence and causes of abnormal urine color in patients with chronic kidney disease: A cross-sectional study Journal of Renal Injury Prevention Year of publication 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365205/
38. Sharma, R., Sharma, A., & Sharma, M. Urine Color: A Potential Indicator of Health Status in Rural Indian Women. Journal of Family Medicine and Primary Care, 2018; 7(3), 447-451. doi: 10.4103/jfmpc.jfmpc_35_18
39. Urinary frequency and functional bladder capacity in patients with chronic kidney disease: a cross-sectional study Published in BMC Nephrology, 2019 https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-019-1397-8
40. Kim JH, Kim H, Kim H, Lee J, Lee JP, et al. Hemoglobin variability and mortality in patients with kidney failure undergoing hemodialysis: A systematic review and meta-analysis. Nephrol Dial Transplant 2018; 33: 2121–2131. https://doi.org/10.1093/ndt/gfy106
41. Santoro A, et al. Blood urea nitrogen and mortality in patients with CKD and ESRD. J Nephrol. 2015;28(3):327-335. https://link.springer.com/article/10.1007/s40620-014-0157-y
42. Mithani S, Akhtar T, Ahmad W, et al. Factors affecting blood urea level in chronic kidney disease patients. Saudi J Kidney Dis Transpl. 2017;28(3):495-501. doi:10.4103/1319-2442.206458
43. Palmer BF, Clegg DJ. Diagnosis and management of kidney disease: a review. JAMA. 2019;322(13):1294-1304. doi:10.1001/jama.2019.14745
44. Santoro A, Mancini E. Urea and beyond: what do we know about nitrogen metabolism in chronic kidney disease? J Nephrol. 2016;29(6):663-667. doi:10.1007/s40620-016-0307-7 https://www.sjkdt.org/article.asp?issn=1319-2442;year=2017;volume=28;issue=3;spage=495;epage=501;aulast=Mithani
45. Levin, A., & Bonventre, J. V. The global challenges of acute kidney injury. Kidney International, 2018; 94(2), 291-293. doi: 10.1016/j.kint.2018.04.023 https://www.kidney-international.org/article/S0085-2538(18)30187-3/fulltext
46. Park JI, Yang DH, Kim YG, et al. Association between anemia and estimated glomerular filtration rate in chronic kidney disease: results from the KoreaN Cohort Study for Outcomes in Patients with Chronic Kidney Disease (KNOW-CKD). BMC Nephrology. 2018;19(1):44. doi:10.1186/s12882-018-0998-y
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Published
2023-08-17
How to Cite
Abed, A. H., Abed, A. H., Naeem, M. A., Ali, R. J., Nayyef, F. H., & Nazar, H. M. (2023). The Percentage of Anemia in Chronic Kidney Disease Patients: A Single Center Study. Central Asian Journal of Medical and Natural Science, 4(4), 423-439. Retrieved from https://cajmns.centralasianstudies.org/index.php/CAJMNS/article/view/1727
Section
Articles
