J Korean Med Sci.  2017 Feb;32(2):249-256. 10.3346/jkms.2017.32.2.249.

The Prevalence and Management of Anemia in Chronic Kidney Disease Patients: Result from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD)

• Ryu SR
• Park SK
• Jung JY
• Kim YH
• Oh YK
• Yoo TH
• Sung S

• KMID: 2364168
• DOI: http://doi.org/10.3346/jkms.2017.32.2.249

Abstract

Anemia is a common and significant complication of chronic kidney disease (CKD). However, its prevalence and current management status has not been studied thoroughly in Korea. We examined the prevalence of anemia, its association with clinical and laboratory factors, and utilization of iron agents and erythropoiesis stimulating agents using the baseline data from the large-scale CKD cohort in Korea. We defined anemia when hemoglobin level was lower than 13.0 g/dL in males and 12.0 g/dL in females, or received by erythropoiesis stimulating agents. Overall prevalence of anemia was 45.0% among 2,198 non-dialysis CKD patients from stage 1 to 5. Diabetic nephropathy (DN) as a cause, CKD stages, body mass index (BMI), smoking, leukocyte count, serum albumin, iron markers, calcium, and phosphorus concentration were identified as independent risk factors for anemia. Considering the current coverage of Korean National Health Insurance System, only 7.9% among applicable patients were managed by intravenous iron agents, and 42.7% were managed by erythropoiesis stimulating agents.

Keyword

Anemia; Chronic Kidney Disease; Korean

MeSH Terms

Anemia*
Body Mass Index
Calcium
Cohort Studies*
Diabetic Nephropathies
Female
Hematinics
Humans
Iron
Korea
Leukocyte Count
Male
National Health Programs
Phosphorus
Prevalence*
Renal Insufficiency, Chronic*
Risk Factors
Serum Albumin
Smoke
Smoking
Calcium
Hematinics
Iron
Phosphorus
Serum Albumin
Smoke

Figure

• 

  Fig. 1 The prevalence of anemia among males and females with CKD according to the CKD stages. The prevalence and the severity of anemia increased with the progression of CKD stages. When compared to the males, females showed higher prevalence of anemia in CKD stage 1–3b. CKD = chronic kidney disease, M = males, F = females. *P < 0.05 for male vs. female.

• 

  Fig. 2 The prevalence of anemia in CKD patients with and without diabetes mellitus according to the CKD stages. DN subgroup exhibited higher prevalence of anemia than the other etiologic subgroups in CKD stage 1–4. CKD = chronic kidney disease, DN = diabetic nephropathy. *P < 0.05 for diabetes vs. non diabetes.

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