日本慢性肾脏病患者贫血的患病率：一项使用日本慢性肾脏病数据库（J-CKD-DB）数据的全国性横断面队列研究。
Prevalence of anemia in patients with chronic kidney disease in Japan: A nationwide, cross-sectional cohort study using data from the Japan Chronic Kidney Disease Database (J-CKD-DB).
机构信息
Division of Nephrology and Dialysis, Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan.
Division of Cardiology, Nephrology, Respiratory and Neurology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.
出版信息
PLoS One. 2020 Jul 20;15(7):e0236132. doi: 10.1371/journal.pone.0236132. eCollection 2020.
BACKGROUND
The Japan Chronic Kidney Disease Database (J-CKD-DB) is a nationwide clinical database of patients with chronic kidney disease (CKD) based on electronic health records. The objective of this study was to assess the prevalence of anemia and the utilization rate of erythropoiesis-stimulating agents (ESAs) in Japanese patients with CKD.
METHODS
In total, 31,082 adult outpatients with estimated glomerular filtration rates of 5-60 ml/min/1.73 m2 in seven university hospitals were included this analysis. The proportions of patients with CKD stages G3b, G4, and G5 were 23.5%, 7.6%, and 3.1%, respectively.
RESULTS
The mean (standard deviation) hemoglobin level of male patients was 13.6 (1.9) g/dl, which was significantly higher than the mean hemoglobin level of female patients (12.4 (1.6) g/dl). The mean (standard deviation) hemoglobin levels were 11.4 (2.1) g/dl in patients with CKD stage G4 and 11.2 (1.8) g/dl in patients with CKD stage G5. The prevalences of anemia were 40.1% in patients with CKD stage G4 and 60.3% in patients with CKD stage G5. Logistic regression analysis showed that diagnoses of CKD stage G3b (adjusted odds ratio [95% confidence interval]: 2.32 [2.09-2.58]), G4 (5.50 [4.80-6.31]), and G5 (9.75 [8.13-11.7]) were associated with increased prevalence of anemia. The utilization rates of ESAs were 7.9% in patients with CKD stage G4 and 22.4% in patients with CKD stage G5.
CONCLUSIONS
We determined the prevalence of anemia and utilization rate of ESAs in Japanese patients with CKD using data from a nationwide cohort study.
背景
日本慢性肾脏病数据库（J-CKD-DB）是基于电子健康记录的全国性慢性肾脏病（CKD）临床数据库。本研究的目的是评估日本 CKD 患者贫血的患病率和促红细胞生成素制剂（ESA）的使用率。
方法
本分析共纳入了七所大学医院中估计肾小球滤过率为 5-60 ml/min/1.73 m2 的 31082 例成年门诊患者。CKD 分期 G3b、G4 和 G5 的患者比例分别为 23.5%、7.6%和 3.1%。
结果
男性患者的平均（标准差）血红蛋白水平为 13.6（1.9）g/dl，明显高于女性患者的平均血红蛋白水平（12.4（1.6）g/dl）。CKD 分期 G4 患者的平均（标准差）血红蛋白水平为 11.4（2.1）g/dl，CKD 分期 G5 患者的平均血红蛋白水平为 11.2（1.8）g/dl。CKD 分期 G4 患者贫血患病率为 40.1%，CKD 分期 G5 患者贫血患病率为 60.3%。Logistic 回归分析显示，CKD 分期 G3b（调整后比值比[95%置信区间]：2.32[2.09-2.58]）、G4（5.50[4.80-6.31]）和 G5（9.75[8.13-11.7]）的诊断与贫血患病率的增加相关。ESA 的使用率在 CKD 分期 G4 患者中为 7.9%，在 CKD 分期 G5 患者中为 22.4%。
结论
我们使用全国性队列研究的数据确定了日本 CKD 患者贫血的患病率和 ESA 的使用率。
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