Kim Dana, Lee Joshua, Toyama Tadashi, Liyanage Thaminda, Woodward Mark, Matsushita Kunihiro, Hooi Lai Seong, Lin Ming-Yen, Iseki Kunitoshi, Jha Vivekanand, Wong Muh Geot, Jun Min
The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Nephrology (Carlton). 2025 Feb;30(2):e70002. doi: 10.1111/nep.70002.
Anaemia is a significant complication of chronic kidney disease (CKD). However, its prevalence and treatment patterns in Asia are poorly understood. We sought to quantify prevalence of anaemia and its treatment in people with CKD across the region.
MEDLINE and Embase (inception to 2023) were systematically searched for observational studies of adults with CKD conducted in Asia that reported the prevalence of anaemia or its treatment. Additional relevant unpublished data were obtained from national experts. Summary estimates of the prevalence of anaemia and its treatment were determined using a random-effects meta-analysis according to country and study-specific CKD inclusion criteria.
Eighty-six studies from 10 Asian countries reported data on 1 342 121 participants. The overall prevalence of anaemia in individuals with CKD was 42% (95% CI 33%-52%), with wide variation (12%-57% in studies including all CKD stages; 21%-96% in studies limited to individuals with kidney failure). Anaemia prevalence progressively increased with more advanced CKD (80% in Stage 5). Studies reporting data on anaemia treatment, particularly in early CKD, were limited. The prevalence of erythropoietin-stimulating agents (ESAs) and iron therapy was 40% (95% CI 24%-58%) and 21% (95% CI 14%-31%), respectively (ESA: 7%-29% in CKD, 63%-95% in kidney failure; iron: 6%-26% in CKD, 15%-88% in kidney failure).
Our findings indicate a significant, but widely varying, prevalence of anaemia and its treatment in people with CKD in Asia. Substantial variability in data availability and collection highlights the need for standardised reporting to facilitate the development of regionally relevant strategies for anaemia management in CKD.
贫血是慢性肾脏病（CKD）的一种重要并发症。然而，亚洲地区贫血的患病率及治疗模式仍鲜为人知。我们旨在量化该地区CKD患者中贫血的患病率及其治疗情况。
系统检索MEDLINE和Embase（建库至2023年）中在亚洲开展的针对成年CKD患者的观察性研究，这些研究报告了贫血患病率或其治疗情况。另外，从各国专家处获取了相关未发表数据。根据国家和研究特定的CKD纳入标准，采用随机效应荟萃分析确定贫血患病率及其治疗情况的汇总估计值。
来自10个亚洲国家的86项研究报告了1342121名参与者的数据。CKD患者中贫血的总体患病率为42%（95%CI 33%-52%），差异较大（涵盖所有CKD阶段的研究中为12%-57%；仅限于肾衰竭患者的研究中为21%-96%）。贫血患病率随CKD病情进展而逐渐升高（5期为80%）。报告贫血治疗数据的研究，尤其是早期CKD患者的治疗数据有限。促红细胞生成素刺激剂（ESA）和铁剂治疗的患病率分别为40%（95%CI 24%-58%）和21%（95%CI 14%-31%）（ESA：CKD患者中为7%-29%，肾衰竭患者中为63%-95%；铁剂：CKD患者中为6%-26%，肾衰竭患者中为15%-88%）。
我们的研究结果表明，亚洲CKD患者中贫血患病率及其治疗情况虽显著，但差异很大。数据可得性和收集方面的巨大差异凸显了标准化报告的必要性，以促进制定与该地区相关的CKD贫血管理策略。
