Prevalence of Anemia and Associated Factors Among Patients with Chronic Kidney Disease Attending A Medical Clinic: A Cross-Sectional Study.

Original Article

Abstract

Background: Anemia is a common condition associated with chronic kidney disease (CKD) in which the production of erythropoietin is decreased, there is iron deficiency, and there is chronic inflammation. It correlates with reduced functional status, cardiovascular complications, higher hospitalization, and lower health-related quality of life. Establishing its prevalence and associated factors is important for early diagnosis and appropriate management.

Objectives: To assess the prevalence of anemia in chronic kidney disease (CKD) patients at a medical clinic and to explore demographic and clinical factors related to anemia in this population.

Methods: This is a cross-sectional study in which 100 adult patients who were confirmed to have CKD, attending the medical outpatient clinic of a tertiary care hospital during six months, were included. Acute kidney injury, pregnancy, hematological malignancy, active bleeding, and a history of blood transfusion were exclusion criteria. Demographic, clinical, and laboratory parameters were gathered, such as hemoglobin, serum creatinine, estimated GFR (eGFR), serum ferritin, and CKD stage. The World Health Organization criteria were used to define anemia. SPSS software 27.0 was used for data analysis. Chi-square and independent t-tests were used to assess associations, and multivariable logistic regression was used to determine independent predictors. The p-value was taken to be <0.05 as statistically significant.

Results: The mean age of participants was 57.6 ± 12.4 years, with 61% males. The prevalence of anemia was 64.0%. Anemic patients had significantly lower hemoglobin levels than non-anemic patients (9.4 ± 1.3 vs. 12.8 ± 1.1 g/dL; p<0.001). Anemia was significantly associated with advanced CKD stages (78.4% vs. 41.7%; p=0.002), diabetes mellitus (p=0.018), hypertension (p=0.041), reduced eGFR (24.7 ± 10.8 vs. 41.9 ± 12.6 mL/min/1.73 m²; p<0.001), and low serum ferritin (p=0.009). Multivariable analysis identified advanced CKD stage (AOR=3.62, p=0.003), diabetes mellitus (AOR=2.41, p=0.021), and reduced eGFR (AOR=2.96, p=0.006) as independent predictors of anemia.

Conclusion: Anemia prevalence was very high, almost 2/3 of the CKD patients, and strongly related to advanced renal disease, diabetes, decreased kidney function, and iron deficiency. Routine screening for anemia and prompt treatment should be part of the routine management of CKD to prevent complications and optimize the health of patients.