Management of anemia in chronic kidney disease patients: baseline findings from Chronic Kidney Disease Japan Cohort Study

Clin Exp Nephrol. 2011 Apr;15(2):248-57. doi: 10.1007/s10157-010-0396-7. Epub 2011 Jan 15.

Abstract

Background: Anemia is a factor that affects the outcome of patients with chronic kidney disease (CKD); however, there are only a few reports on the management of anemia in Japanese patients with CKD who are not on dialysis.

Methods: We investigated the prevalence, related factors and management of anemia in CKD stage 3-5 patients in Japan based on the baseline data obtained from a prospective cohort study (Chronic Kidney Disease Japan Cohort). Anemia was defined as having a hemoglobin (Hb) level of <11 g/dL or receiving erythropoiesis stimulating agent (ESA) therapy.

Results: The result indicated that 946 out of 2,930 patients had anemia. Of these 946 patients, 385 were receiving ESA treatment for anemia and had an Hb level of 10.28 ± 1.19 g/dL (mean ± SD). The percentage of these patients with an Hb level above the target of 11 g/dL proposed for treatment by the Japanese guidelines, and above the maintenance level of 10 g/dL approved for ESA therapy in Japan, was only 30.1 and 61.6%, respectively. In contrast, the percentage of patients receiving no ESA therapy was 67.6 and 55.7%, respectively, among those with an Hb level of <11 and <10 g/dL.

Conclusions: These data suggested that prevalence of anemia was high in Japanese patients with CKD stage 3-5, that the percentage of patients receiving ESA was low among those who required ESA, and that a large number of patients receiving ESA failed to maintain the recommended level of Hb.

MeSH terms

  • Adult
  • Aged
  • Anemia / etiology
  • Anemia / therapy*
  • Diabetic Nephropathies / complications
  • Female
  • Glomerular Filtration Rate
  • Hematinics / administration & dosage*
  • Hemoglobins / metabolism*
  • Humans
  • Japan
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Treatment Outcome

Substances

  • Hematinics
  • Hemoglobins