2021 Volume 3 Issue 1 Pages 27-35
BACKGROUND
Although anemia is an important factor determining renal and cardiovascular outcomes in patients with chronic kidney disease (CKD), reports on the status of anemia management in Japanese patients with pre-dialysis CKD are limited.
METHODS
We retrospectively analyzed CKD patients follow-up at our department between June 2012 and July 2014 (Fukushima CKD cohort study), for the management status of anemia and differences in anemia control under the current treatment strategy, including long-acting erythropoiesis stimulating agents (ESA), classified according to the underlying renal disease, namely primary renal disease, hypertensive nephropathy, diabetic nephropathy, and others. Anemia was defined as a hemoglobin level of <11 g/dL, or receiving ESA therapy.
RESULTS
We identified 1,324 patients with CKD, and found that the prevalence of anemia increased with CKD stage, and was significantly higher in diabetic nephropathy than primary renal disease and hypertensive nephropathy (25.3%, 12.9%, and 10.9%, respectively, P <0.001). Anemia was independently related to the underlying renal disease, with a significant difference between diabetic nephropathy and primary renal disease (odds ratio 2.15; 95% confidence interval, 1.16–3.99, P = 0.015). Among those with hemoglobin <11 g/dL, 57.1% of patients were not on ESAs. The mean hemoglobin level was 10.4 ± 1.0 g/dL and achievement rate of a target hemoglobin of ≥11 g/dL, recommended in Japanese guidelines, was 30.1% among subjects on ESA therapy.
CONCLUSIONS
These results suggest that intervention for renal anemia is not necessarily adequate among Japanese patients with CKD, even those under nephrologist care, including with use of long-acting ESAs.
