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慢性肾脏病患者贫血的患病率及管理:韩国慢性肾脏病患者结局队列研究(KNOW-CKD)的结果

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).

作者信息

Ryu Sang Ryol, Park Sue K, Jung Ji Yong, Kim Yeong Hoon, Oh Yun Kyu, Yoo Tae Hyun, Sung Suah

机构信息

Department of Internal Medicine, Yeosu Chonnam Hospital, Yeosu, Korea.

Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2017 Feb;32(2):249-256. doi: 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.

摘要

贫血是慢性肾脏病(CKD)常见且严重的并发症。然而,韩国尚未对其患病率及当前管理状况进行全面研究。我们利用韩国大规模CKD队列的基线数据,研究了贫血的患病率、其与临床及实验室因素的关联,以及铁剂和促红细胞生成素的使用情况。我们将男性血红蛋白水平低于13.0 g/dL、女性低于12.0 g/dL或接受促红细胞生成素治疗定义为贫血。在2198例1至5期非透析CKD患者中,贫血的总体患病率为45.0%。糖尿病肾病(DN)作为病因、CKD分期、体重指数(BMI)、吸烟、白细胞计数、血清白蛋白、铁指标、钙和磷浓度被确定为贫血的独立危险因素。考虑到韩国国民健康保险系统的当前覆盖范围,在适用患者中,仅7.9%接受静脉铁剂治疗,42.7%接受促红细胞生成素治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5293/5219990/b3131c89c470/jkms-32-249-g001.jpg

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