Prevalence, associations and treatment outcome of anaemia in a cohort of patients with Chronic Kidney Disease

Abstract

INTRODUCTION & OBJECTIVES: Anaemia is a common complication of chronic kidney disease (CKD) that can adversely affect cardiovascular health and quality of life. We conducted a study to assess prevalence, associations and treatment response of anaemia in a cohort of patients with CKD. METHODS: A descriptive cross sectional study was conducted among consecutive, consenting adult patients with stable CKD attending clinics and wards of University Medical Unit, Colombo North Teaching Hospital, Ragama. RESULTS: Of 149 patients with CKD [86/149 males (57.7%)], 105 (70.5%) had diabetes, 125 (83.9%) had hypertension and 57 (37.6%) had ischemic heart disease. 58/63 (90.6%) females and 80/86 (93%) males had anaemia. Severity of anaemia was associated with female sex (p=0.02), advancing CKD stage (p<0.01), diabetes (p=0.03), chronic liver cell disease (p=0.03), being on dialysis (p<0.005) and increasing degree of proteinuria (p<0.001). Of 91 patients investigated for the cause of anaemia, 55/91 (60.4%) had iron deficiency with anaemia of chronic disease while 25/91 (27.5%) had anaemia of chronic disease only. Of 88 patients with haemoglobin <10g/dL, only 40 (45.4%) were on erythropoietin and 50 (56.8%) had received blood transfusions. 76.1% (67/88) of the anaemic patients continued to have hemoglobin below 10g/dL at follow up despite treatment. CONCLUSION: Anaemia was highly prevalent in the CKD cohort we studied, compared to similar populations in other countries. Timely evaluation of anaemia, treatment of coexistent nutritional deficiencies and initiation of erythropoietin therapy are important to prevent anaemia-related complications and minimize the need for transfusions.