Epidemiology and Burden of Anemia in CKD: A Literature Review

Boston—According to Milena Anatchkova, PhD, and colleagues, there are no recent reviews describing the epidemiology and burden of anemia in patients with chronic kidney disease (CKD) in the United States. The researchers recently conducted a study designed to address this evidence gap by examining and summarizing existing evidence of the epidemiologic burden of anemia in CKD. Results of the study were reported during a poster session at the NKF Spring Clinical Meetings in a poster titled Targeted Review of the Epidemiology and Burden of Anemia in Chronic Kidney Disease. The researchers utilized a targeted review approach to develop preselected criteria and outcomes. Searches were conducted in Medline, EMBASE, and proceedings from recent conferences to identify research into the epidemiologic burden of CKD anemia in the United States since 2013. The focus of the review was on natural disease history, incidence, prevalence, mortality, and disease severity. A total of 667 publications were screened. Of those, 30 were included in the qualitative analysis. There were significant associations between anemia in CKD and female sex (n=4), older age (n=5), non-white race (n=4), and history of anemia (n=2). In ten studies of diverse populations, there was wide variation in prevalence of anemia in CKD (range: 15%-69%); prevalence rates were closely associated with older age and disease severity. All-cause mortality was reported in four studies (range, 15%-35%). Of two studies examining associations between anemia and mortality, one reported a non-significant association. Findings for the association of mortality outcomes with anemia treatments (erythropoietin-stimulating agents and/or iron supplements) were mixed in nine studies. None of the studies reported data on the incidence of anemia in CKD. In conclusion, the researchers said, “The literature review identified few studies and reports a wide range of prevalence data for anemia in CKD, with little insight relating to the relationship between mortality and anemia, and possible factors associated with natural disease history. Given the sparse data, epidemiologic burden remains a gap in peer-reviewed literature, especially with respect to incidence of anemia in CKD in the United States over the last 5 years.” Source: Anatchkova M, Brooks A, Earley A, et al. Targeted review of the epidemiology and burden of anemia in chronic kidney disease. Abstract of a poster presented at the National Kidney Foundation 2019 Spring Clinical Meetings, May 8-12, 2019, Boston, Massachusetts.