ABSTRACT
OBJECTIVE:
s To investigate the
prevalence, clinical features,
risk factors and
treatment of
anemia in
patients with stage3 a-5 D CKD at high
altitude.
METHODS:
A total of 525
patients with stage3 a-5 D CKD admitted to Diqing Tibetan Autonomous Prefecture People's
Hospital between Nov.2017 and Nov.2018 were enrolled in this
cross-sectional study, and then categorized into 5 groups according to eGFR and whether depending on
dialysis. Clinical and
laboratory data were collected and analyzed to study the
prevalence, clinical features,
risk factors as well as the
treatment of
anemia in these CKD
patients.
RESULTS:
Among 525
patients with stage3 a-5 D CKD(average age59.2 ± 15.4 ys,CKD stagingstage3 an = 269;stage3 bn=113;stage4n=56;stage5n=36;stage5 Dn=51),
anemia was established in 233(44.4%)
patients, 68.2% of which had mild
anemia. The
prevalence of anemie was 29%,33.6%64.3%,88.9% and 96.1,respectively from stage 3 a to stage 5 D, and the
prevalence increased and the severity of
anemia deteriorated with CKD progression, along with other clinical
parameters including
serum creatinine,
albumin,
uric acid,MDRD-eGFR, and
calcium and
phosphorus metabolism.
Logistic regression analysis showed that advanced CKD stage(OR=2.206,P<0.001),
hypoalbuminemia(OR=0.919,P=0.034), lower BMI(OR=0.868,P=0.012)and low
serum calcium(OR=0.062,P=0.019)were independent
risk factors for
anemia in CKD
patients at high
altitude. Among 233
patients with
anemia, only 37.7% had ever received
treatment for
anemia and the average
hemoglobin concentration when initiating the
treatment was(79.9±19.3)g/L.
Erythropoietin was not widely used and the target-achieving rate was only 37.5%(33/88).
CONCLUSION:
s The
prevalence of
anemia increases with CKD progression in CKD
patients at high
altitude. Advanced CKD stage,
hypoalbuminemia, lower BMI and low
serum calcium are independent
risk factors for
anemia. The general situation of
treatment for
anemia is not good,with late starting
time of
treatment and low
treatment rate,low rate in EPO use and low target-achieving rate,which should be paid affention to.