Kovesdy Csaba P, Davis Jill R, Duling Ian, Little Dustin J
Department of Medicine, Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA.
Payer Evidence, AstraZeneca, Wilmington, DE, USA.
Clin Kidney J. 2022 Nov 12;16(2):303-311. doi: 10.1093/ckj/sfac240. eCollection 2023 Feb.
Population-based estimates of anaemia prevalence in patients with chronic kidney disease (CKD) vary, and data on the prevalence of severe anaemia of CKD are limited. This study examined the prevalence of anaemia and anaemia eligible for erythropoiesis-stimulating agent (ESA) treatment in patients with CKD in the USA.
National Health and Nutrition Examination Survey (NHANES) data from 1999-2000 to 2017-18 were used to determine the prevalence of diagnosed anaemia (haemoglobin <12 g/dL in women; <13 g/dL in men) and anaemia eligible for ESA treatment (haemoglobin <10 g/dL) in survey participants aged ≥18 years with stage 3-5 non-dialysis-dependent CKD (estimated glomerular filtration rate <60 mL/min/1.73 m). The study objectives were to (i) obtain a more recent estimate of anaemia prevalence in patients with non-dialysis-dependent CKD and (ii) examine the characteristics of individuals with CKD and haemoglobin <10 g/dL.
Of 51 163 eligible NHANES participants, 2926 (5.7%) with stage 3-5 CKD were included. In all participants, the weighted prevalences of anaemia and haemoglobin <10 g/dL were 25.3% and 1.9%, respectively. Mean haemoglobin levels decreased numerically between 1999 and 2012 and remained stable thereafter. The prevalence of anaemia and haemoglobin <10 g/dL increased with advancing CKD stage. The odds of haemoglobin <10 g/dL were significantly higher in stage ≥3B versus 3A and in non-Hispanic Blacks versus other races.
In our analysis, approximately 25% of individuals with stage 3-5 CKD in the USA had anaemia and approximately 2% had anaemia eligible for ESA treatment.
基于人群的慢性肾脏病（CKD）患者贫血患病率估计值各不相同，且关于CKD严重贫血患病率的数据有限。本研究调查了美国CKD患者的贫血患病率以及符合促红细胞生成素（ESA）治疗条件的贫血患病率。
使用1999 - 2000年至2017 - 18年的美国国家健康与营养检查调查（NHANES）数据，确定年龄≥18岁、患有3 - 5期非透析依赖性CKD（估计肾小球滤过率<60 mL/min/1.73 m²）的调查参与者中诊断为贫血（女性血红蛋白<12 g/dL；男性<13 g/dL）以及符合ESA治疗条件的贫血（血红蛋白<10 g/dL）的患病率。研究目标为：（i）获得非透析依赖性CKD患者贫血患病率的最新估计值；（ii）研究CKD且血红蛋白<10 g/dL患者的特征。
在51163名符合条件的NHANES参与者中，纳入了2926名（5.7%）3 - 5期CKD患者。在所有参与者中，贫血和血红蛋白<10 g/dL的加权患病率分别为25.3%和1.9%。1999年至2012年期间，血红蛋白平均水平呈数字下降，此后保持稳定。贫血和血红蛋白<10 g/dL的患病率随CKD分期进展而增加。≥3B期患者血红蛋白<10 g/dL的几率显著高于3A期，非西班牙裔黑人患者高于其他种族。
在我们的分析中，美国约25%的3 - 5期CKD患者患有贫血，约2%患有符合ESA治疗条件的贫血。
