Objective: To assess the prevalence, risk factors and treatment of anemia in patients with chronic kidney disease (CKD). Methods: A descriptive method was used to analyze the prevalence and treatment of anemia in CKD patients based on regional health data in Yinzhou District of Ningbo during 2012-2018. The multivariate logistic regression analysis was used to identify independent influence factors of anemia in the CKD patients. Results: In 52 619 CKD patients, 15 639 suffered from by anemia (29.72%), in whom 5 461 were men (26.41%) and 10 178 were women (31.87%), and anemia prevalence was higher in women than in men, the difference was significant (P<0.001). The prevalence of anemia increased with stage of CKD (24.77% in stage 1 vs. 69.42% in stage 5, trend χ2 test P<0.001). Multivariate logistic regression analysis revealed that being women (aOR=1.57, 95%CI: 1.50-1.63), CKD stage (stage 2: aOR=1.10, 95%CI: 1.04-1.16;stage 3: aOR=2.28,95%CI: 2.12-2.44;stage 4: aOR=4.49,95%CI :3.79-5.32;stage 5: aOR=6.31,95%CI: 4.74-8.39), age (18-30 years old: aOR=2.40,95%CI: 2.24-2.57, 61-75 years old: aOR=1.35,95%CI:1.28-1.42, ≥76 years old: aOR=2.37,95%CI:2.20-2.55), BMI (<18.5 kg/m2:aOR=1.29,95%CI: 1.18-1.41;23.0-24.9 kg/m2:aOR=0.79,95%CI: 0.75-0.83;≥25.0 kg/m2:aOR=0.70,95%CI: 0.66-0.74), abdominal obesity (aOR=0.91, 95%CI: 0.86-0.96), chronic obstructive pulmonary disease (aOR=1.15, 95%CI: 1.09-1.22), cancer (aOR=3.03, 95%CI: 2.84-3.23), heart failure (aOR=1.44, 95%CI: 1.35-1.54) and myocardial infarction (aOR=1.54, 95%CI:1.16-2.04) were independent risk factors of anemia in CKD patients. Among stage 3-5 CKD patients with anemia, 12.03% received iron therapy, and 4.78% received treatment with erythropoiesis-stimulating agent (ESA) within 12 months after anemia was diagnosed. Conclusions: The prevalence of anemia in CKD patients was high in Yinzhou. However, the treatment rate of iron therapy and ESA were low. More attention should be paid to the anemia management and treatment in CKD patients.
目的： 分析慢性肾脏病（CKD）患者的贫血患病率、影响因素及治疗情况。 方法： 采用描述性统计分析方法分析2012-2018年宁波市鄞州区域健康信息平台中CKD患者贫血患病情况及贫血患病后12个月内接受治疗的情况；采用多因素logistic回归模型分析CKD患者贫血患病的影响因素。 结果： 共纳入52 619例新发CKD患者，有15 639例（29.72%）CKD患者存在贫血，其中女性贫血患者10 178例（31.87%），男性贫血患者5 461例（26.41%），女性CKD患者贫血患病率高于男性，差异有统计学意义（P<0.001）。贫血患病率随着CKD分期的进展而增加（趋势检验P<0.001），由1期的24.77%增长至5期的69.42%。多因素logistic回归分析显示，CKD贫血患病主要的影响因素有性别（女性：aOR=1.57，95%CI：1.50~1.63）、CKD分期（2期：aOR=1.10，95％CI：1.04~1.16；3期：aOR=2.28，95%CI：2.12~2.44；4期：aOR=4.49，95%CI：3.79~5.32；5期：aOR=6.31，95%CI：4.74~8.39）、年龄（18~30岁：aOR=2.40，95%CI：2.24~2.57；61~75岁：aOR=1.35，95%CI：1.28~1.42；≥76岁：aOR=2.37，95%CI：2.20~2.55）、BMI（<18.5 kg/m2：aOR=1.29，95%CI：1.18~1.41；23.0~24.9 kg/m2：aOR=0.79，95%CI：0.75~0.83；≥25.0 kg/m2：aOR=0.70，95%CI：0.66~0.74）、腹型肥胖（aOR=0.91，95%CI：0.86~0.96）、慢性阻塞性肺疾病（aOR=1.15，95%CI：1.09~1.22）、恶性肿瘤（aOR=3.03，95%CI：2.84~3.23）、心力衰竭（aOR=1.44，95%CI：1.35~1.54）及心肌梗死（aOR=1.54，95%CI：1.16~2.04）。有12.03%的3~5期CKD贫血患者在12个月内接受了铁剂治疗，4.78%的患者接受了红细胞生成刺激剂（ESA）治疗。 结论： 宁波市鄞州区CKD患者贫血患病率较高，铁剂及ESA治疗率偏低，应加强CKD患者的贫血管理与治疗。.