Prevalence of anaemia and its clinical management in patients with stages 3-5 chronic kidney disease not on dialysis in Catalonia: MICENAS I study.

INTRODUCTION

Anaemia is a common complication of chronic kidney disease (CKD). The aim of this study was to determine the prevalence and clinical management of anaemia in patients with stages 3-5 CKD not on dialysis treated in outpatient Nephrology clinics (OC) in Catalonia.

METHODS

Epidemiological, cross-sectional cohort, multicentre study under routine clinical practice conditions. Data collection by electronic data collection log-book (e-DCL) including personal information and data related to anaemia (haemoglobin, iron status, treatment with erythropoiesis-stimulating agents [ESA] and other anaemia treatments). Anaemia was defined as haemoglobin levels <13.5 g/dL in males or <12 g/dL in females or patients who receive treatment with ESA.

RESULTS

We included 504 patients (56.4% male, mean age of 67.8 ± 15.5 years): 61.5% had stage 3 CKD, 30.2% stage 4 and 8.3% stage 5. The main causes of CKD were vascular and diabetic nephropathy. The prevalence of anaemia was 58.5% (n=295), however, only 14.9% of patients had haemoglobin levels <11 g/dL. Mean haemoglobin levels decreased and ESA treatment was more common as CKD progressed, but no significant differences were observed regarding the prescription of iron, according to CKD stages. ESA and intervals most frequently prescribed were darbepoetin alfa with a median dose of 40 μg/biweekly, followed by C.E.R.A. with a median dose of 75 μg/month and epoetin beta with a median dose of 5,000 IU/week. Among the patients with anaemia (n=295), 36.3% (n=107) had iron deficiency and only 53.3% of these patients were treated with iron supplements.

CONCLUSIONS

This study demonstrates the high prevalence of anaemia, which increases as the disease progresses and its good control in a CKD patient population treated in Nephrology outpatient clinics in Catalonia. This control is achieved with moderate doses of ESA and iron supplements prescribed in more than 50% of anaemic CKD patients.