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Prevalence and Prognosis of Mild Anemia in Non-Dialysis Chronic Kidney Disease: A Prospective Cohort Study in Outpatient Renal Clinics

2010; Karger Publishers; Volume: 32; Issue: 6 Linguagem: Inglês

10.1159/000321468

1421-9670

Luca De Nicola, Roberto Minutolo, Paolo Chiodini, Pasquale Zamboli, Bruno Cianciaruso, Felice Nappi, Simona Signoriello, Giuseppe Conte, Carmine Zoccali,

Hemoglobinopathies and Related Disorders

we evaluated prevalence and prognosis of mild anemia, defined as Hb (g/dl) 11-13.5 in males and 11-12 in females, in a prospective cohort of stage 3-5 chronic kidney disease (CKD) patients.we enrolled 668 consecutive patients in 25 renal clinics during 2003. Patients with frank anemia (Hb <11 or erythropoiesis-stimulating agents) at enrolment were excluded. Mild anemia was evaluated at two visits planned with an interval of 18 ± 6 months to identify four categories: no anemia at both visits, mild anemia at visit 1 resolving at visit 2 (RES), mild anemia persisting at both visits (PER), and progression from no anemia or mild anemia at visit 1 to mild or frank anemia at visit 2 (PRO).mild anemia was present in 41.3% at visit 1 and 34.1% at visit 2. We identified PER in 22% patients, RES in 10%, and PRO in 26%. In the subsequent 40 months, 125 patients developed end-stage renal disease (ESRD) and 94 died. At competing risk model, PER predicted ESRD (hazard ratio, HR, 1.82, 95% confidence interval, CI, 1.01-3.29) while PRO predicted both ESRD (HR 1.81, 95% CI 1.02-3.23) and death (HR 1.87, 95% CI 1.04-3.37).in non-dialysis chronic kidney disease, mild anemia is prevalent and it is a marker of risk excess when persistent or progressive over time.