The following is a summary of “Anemia Prevalence, Type, and Associated Risks in a Cohort of 5.0 Million Insured Patients in the United States by Level of Kidney Function,” published in the February 2023 issue of the Kidney Diseases by Farrington et al.

Even though anemia is linked to poor outcomes in CKD, the current treatment options are inadequate. Researchers estimated glomerular filtration rate (eGFR) and hemoglobin level to define anemia’s prevalence, risk factors, and consequences. Extracted from the Optum Labs Data Warehouse is outpatient information for 5,004,957 people treated at 57 hospitals in the United States between 2016 and 2019. Test results show low iron levels and the eGFR severity of anemia. Renal failure requiring dialysis or a transplant, coronary artery disease, stroke, heart failure, or death as a complication of chronic renal disease.

Using a gender and eGFR stratification, Researchers identified the rates of anemia, poor iron test results, vitamin B12 deficiency, and the use of erythropoiesis-stimulating agents (ESAs). Next, the adjusted odds ratios of hemoglobin levels across eGFR were estimated using polychotomous logistic regression. Finally, hemoglobin levels were used with Cox proportional hazards regression to get the adjusted hazard ratios for bad outcomes.

The average age was 54; men comprised 42% of the population. The prevalence of anemia was significantly higher in those with lower eGFR, even after controlling for other factors. Anemia patients’ iron levels were rarely evaluated, but of those who were, 60.4% of men and 81.3% of women had low iron test results. The use of ESAs was low, at around 4%. A higher risk of acute renal failure requiring replacement therapy, cardiovascular disease, coronary heart disease, stroke, heart failure, and death was found to be independently related to lower hemoglobin. Severe anemia was prevalent and linked to decreased eGFR and a host of other negative results. Despite iron studies being checked rarely, low-iron test findings were common among those examined. Patients with CKD who did not undergo dialysis rarely used ESAs.

Source: sciencedirect.com/science/article/pii/S0272638622009143