Risk of Anemia in Patients with Newly Identified Chronic Kidney Disease – A Population-Based Cohort Study

Søren Viborg Vestergaard,1 Uffe Heide-Jørgensen,1 Heleen van Haalen,2 Glen James,3 Katarina Hedman,4 Henrik Birn,5,6 Reimar Wernich Thomsen,1 Christian Fynbo Christiansen1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Health Economics &...

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Main Authors: Vestergaard SV, Heide-Jørgensen U, van Haalen H, James G, Hedman K, Birn H, Thomsen RW, Christiansen CF
Format: Article
Language:English
Published: Dove Medical Press 2020-09-01
Series:Clinical Epidemiology
Subjects:
Online Access:https://www.dovepress.com/risk-of-anemia-in-patients-with-newly-identified-chronic-kidney-diseas-peer-reviewed-article-CLEP
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author Vestergaard SV
Heide-Jørgensen U
van Haalen H
James G
Hedman K
Birn H
Thomsen RW
Christiansen CF
author_facet Vestergaard SV
Heide-Jørgensen U
van Haalen H
James G
Hedman K
Birn H
Thomsen RW
Christiansen CF
author_sort Vestergaard SV
collection DOAJ
description Søren Viborg Vestergaard,1 Uffe Heide-Jørgensen,1 Heleen van Haalen,2 Glen James,3 Katarina Hedman,4 Henrik Birn,5,6 Reimar Wernich Thomsen,1 Christian Fynbo Christiansen1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Health Economics & Payer Evidence, AstraZeneca, Gothenburg, Sweden; 3Epidemiology, AstraZeneca, Cambridge, UK; 4Biometrics, AstraZeneca, Gothenburg, Sweden; 5Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark; 6Department of Biomedicine, Aarhus University, Aarhus, DenmarkCorrespondence: Søren Viborg VestergaardDepartment of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N 8200, DenmarkTel +45 87168514Email sovi@clin.au.dkPurpose: Anemia is prevalent in patients with chronic kidney disease (CKD), but the longitudinal risk of anemia in patients with newly identified CKD is unknown. We therefore examined the risks of experiencing anemia in persons with newly identified CKD.Patients and Methods: This cohort study included adult patients with newly identified CKD stages 3– 5 defined by an estimated glomerular filtration rate (eGFR) level < 60 mL/min/1.73m2 (at least two measurements ≥ 90 days apart) ascertained from a population-based registry with complete laboratory test results in Northern Denmark (population ∼ 2.2 million) during 2009– 2016. We calculated 1) cumulative incidence (risk) of anemia [hemoglobin < 12/< 13 g/dl in women/men] by CKD stage, and 2) adjusted hazard ratios (HRs) of anemia using Cox regression analyses.Results: We identified 55,940 distinct individuals with newly identified CKD stages 3– 5 and no prevalent anemia [n=41,958 patients in stage 3a, n=17,875 in stage 3b, n=5182 in stage 4, and n=931 in stage 5]. After one year, 42.3% (95%-confidence interval [CI]: 41.9– 42.7) of patients with CKD stages 3– 5 had newly measured anemia, increasing to 67.7% (95%-CI: 67.2– 68.2) after five years. The absolute and relative anemia risk increased markedly with higher CKD stages. The adjusted HR of any anemia was 5.42 (95%-CI: 5.09– 5.77) in patients with CKD stage 5 compared to patients with CKD stage 3a.Conclusion: Patients with newly identified CKD stages 3– 5 have a substantial risk of anemia, increasing with higher CKD stages. This study underlines that clinical awareness of anemia risk is important in patients with newly identified or progressed CKD.Keywords: anemia, chronic kidney disease, CKD, epidemiology, cohort study
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spelling doaj.art-0efba16d41dc4dfba93ae7a14afbbe292022-12-21T17:25:04ZengDove Medical PressClinical Epidemiology1179-13492020-09-01Volume 1295396256951Risk of Anemia in Patients with Newly Identified Chronic Kidney Disease – A Population-Based Cohort StudyVestergaard SVHeide-Jørgensen Uvan Haalen HJames GHedman KBirn HThomsen RWChristiansen CFSøren Viborg Vestergaard,1 Uffe Heide-Jørgensen,1 Heleen van Haalen,2 Glen James,3 Katarina Hedman,4 Henrik Birn,5,6 Reimar Wernich Thomsen,1 Christian Fynbo Christiansen1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Health Economics & Payer Evidence, AstraZeneca, Gothenburg, Sweden; 3Epidemiology, AstraZeneca, Cambridge, UK; 4Biometrics, AstraZeneca, Gothenburg, Sweden; 5Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark; 6Department of Biomedicine, Aarhus University, Aarhus, DenmarkCorrespondence: Søren Viborg VestergaardDepartment of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N 8200, DenmarkTel +45 87168514Email sovi@clin.au.dkPurpose: Anemia is prevalent in patients with chronic kidney disease (CKD), but the longitudinal risk of anemia in patients with newly identified CKD is unknown. We therefore examined the risks of experiencing anemia in persons with newly identified CKD.Patients and Methods: This cohort study included adult patients with newly identified CKD stages 3– 5 defined by an estimated glomerular filtration rate (eGFR) level < 60 mL/min/1.73m2 (at least two measurements ≥ 90 days apart) ascertained from a population-based registry with complete laboratory test results in Northern Denmark (population ∼ 2.2 million) during 2009– 2016. We calculated 1) cumulative incidence (risk) of anemia [hemoglobin < 12/< 13 g/dl in women/men] by CKD stage, and 2) adjusted hazard ratios (HRs) of anemia using Cox regression analyses.Results: We identified 55,940 distinct individuals with newly identified CKD stages 3– 5 and no prevalent anemia [n=41,958 patients in stage 3a, n=17,875 in stage 3b, n=5182 in stage 4, and n=931 in stage 5]. After one year, 42.3% (95%-confidence interval [CI]: 41.9– 42.7) of patients with CKD stages 3– 5 had newly measured anemia, increasing to 67.7% (95%-CI: 67.2– 68.2) after five years. The absolute and relative anemia risk increased markedly with higher CKD stages. The adjusted HR of any anemia was 5.42 (95%-CI: 5.09– 5.77) in patients with CKD stage 5 compared to patients with CKD stage 3a.Conclusion: Patients with newly identified CKD stages 3– 5 have a substantial risk of anemia, increasing with higher CKD stages. This study underlines that clinical awareness of anemia risk is important in patients with newly identified or progressed CKD.Keywords: anemia, chronic kidney disease, CKD, epidemiology, cohort studyhttps://www.dovepress.com/risk-of-anemia-in-patients-with-newly-identified-chronic-kidney-diseas-peer-reviewed-article-CLEPanemiachronic kidney disease (ckd)epidemiologycohort study
spellingShingle Vestergaard SV
Heide-Jørgensen U
van Haalen H
James G
Hedman K
Birn H
Thomsen RW
Christiansen CF
Risk of Anemia in Patients with Newly Identified Chronic Kidney Disease – A Population-Based Cohort Study
Clinical Epidemiology
anemia
chronic kidney disease (ckd)
epidemiology
cohort study
title Risk of Anemia in Patients with Newly Identified Chronic Kidney Disease – A Population-Based Cohort Study
title_full Risk of Anemia in Patients with Newly Identified Chronic Kidney Disease – A Population-Based Cohort Study
title_fullStr Risk of Anemia in Patients with Newly Identified Chronic Kidney Disease – A Population-Based Cohort Study
title_full_unstemmed Risk of Anemia in Patients with Newly Identified Chronic Kidney Disease – A Population-Based Cohort Study
title_short Risk of Anemia in Patients with Newly Identified Chronic Kidney Disease – A Population-Based Cohort Study
title_sort risk of anemia in patients with newly identified chronic kidney disease ndash a population based cohort study
topic anemia
chronic kidney disease (ckd)
epidemiology
cohort study
url https://www.dovepress.com/risk-of-anemia-in-patients-with-newly-identified-chronic-kidney-diseas-peer-reviewed-article-CLEP
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