Salman Muhammad, Khan Amer Hayat, Adnan Azreen Syazril, Sulaiman Syed Azhar Syed, Hussain Khalid, Shehzadi Naureen, Islam Muhammad, Jummaat Fauziah
PharmD, MSc. Doctoral Student, Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Penang, Malaysia. Lecturer, University College of Pharmacy, University of the Punjab, Lahore, Pakistan.
BPharm, MPhil, PhD. Senior Lecturer, Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, USM, Penang, Malaysia.
Rev Assoc Med Bras (1992). 2016 Nov;62(8):742-747. doi: 10.1590/1806-9282.62.08.742.
: Anemia, a common complication of chronic kidney diseases (CKD), is involved in significant cardiovascular morbidity. Therefore, the objective of our study was to investigate the prevalence and severity of anemia in pre-dialysis patients, as well as to determine the predictors of anti-anemic therapy.
: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013.
: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD.
: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.
贫血是慢性肾脏病（CKD）的常见并发症，与显著的心血管发病率相关。因此，我们研究的目的是调查透析前患者贫血的患病率和严重程度，并确定抗贫血治疗的预测因素。
对2009年1月至2013年12月在马来西亚理科大学医院接受治疗的成年透析前患者进行了一项回顾性观察研究。
共纳入615例符合条件的病例。患者的平均年龄为64.1±12.0岁。贫血患病率为75.8%，47.7%的患者贫血程度为轻度，32.2%为中度，20%为重度。根据贫血的形态学分类，76.9%的患者为正细胞正色素性贫血，而21.8%和1.3%的患者分别为低色素小细胞性贫血和大细胞性贫血。38.0%的患者接受了口服铁补充剂治疗，没有患者接受促红细胞生成素稳定药物（ESA）或静脉铁制剂治疗。在逻辑回归中，抗贫血制剂使用的显著预测因素是血红蛋白和血细胞比容降低以及CKD晚期。
本研究结果表明，透析前患者贫血的患病率高于目前公认的水平，且发现与肾功能相关；患病率随肾功能下降而增加。早期识别和适当管理贫血不仅会对生活质量产生积极影响，还会减少CKD患者因心血管事件而住院的次数。
