High Prevalence of Anemia in Predialysis Patients in Enugu, Nigeria

Abstract

Anemia is common in chronic kidney disease (CKD) and contributes to adverse clinical outcomes. African Americans have a 3-fold increased likelihood of anemia compared with whites. Little is known about the prevalence of anemia of CKD among Nigerians. This study investigated the prevalence of anemia in all stages of CKD and the relationship of anemia to the etiology of CKD. Consecutive predialysis patients in all stages of CKD from 2004 to 2008 at first evaluation in a tertiary hospital renal clinic, and sex and age matched control subjects, were studied. Demographic data, and results of biochemical and hematologic indices cause of CKD were extracted from patients' records and analyzed using SPSS version 15. All tests were two-tailed, and P<0.05 taken to be statistically significant. Three hundred and sixty-four patients (mean age 44.8∓14.8 years) and 143 control subjects (mean age 43.52∓12.00 years, P=0.35) were analyzed. Overall 77.5% of CKD patients and 11.9% (P<0.001) of control subjects had anemia defined as hemoglobin less than 12 g/dL. Anemia increased progressively with declining GFR with mean hemoglobin concentration of 12.91∓1.35 g/dL, 12.14∓1.96, 10.57∓2.42, 8.84∓2.19 and 7.33∓1.74 for CKD stages 1 to 5, respectively. Multiple regression analysis showed chronic glomerulonephritis (CGN), human immunodeficiency/retroviral disease, collagen vascular disease and chronic pyelonephritis predicted anemia in CKD. Anemia was seen at all stages of CKD and progressed from CKD stage 1 to 5. Anemia was worse in women for all stages of CKD.