Anemia associated renal functional impairment without dialysis requirements current situation in Argentina. APREDIA Study
Abstract
Introduction: The objective of APREDIA (Anemia predialysis) study was to detect the prevalence of anemia in patients with Chronic Kidney Disease
(CKD) in predialysis stage and evaluate its management. Methods: For this purpose, a cross-sectional data survey of patients with a glomerular filtration rate (GF) ≤ 44.4 ml/min (Cockcroft Gault) was performed, in which other causes of anemia and/or evidence of active bleeding were excluded. Hemoglobin (Hb) < 13 g/dl for men and 12 g/dl for women defined anemia in our study. Results: Data requested were: cause of CKD, laboratories, and treatments. Data of 611 patients (age 71.4 ± 14 years) were included. 50% of patients had been diagnosed with CKD 2 or more years ago. 71.7% had a Hb value compatible with anemia (74% males; 69% females); 64% of those who had GF between 44.4 and 30 ml/min and 91% of those with GF ≤ 15 ml/min. The Hb medium value of the whole population was 11.4 g/dl, being lower as the GF decreased. Only 35% of the patients had a ferritin and iron serum measures, and only 50.9% of those who had anemia were receiving iron therapy, most of them orally. 22.2% of anemic patients received erythropoiesis-stimulating agents (ESAs), 31.2% of those who had a GF < 30 ml/min and 10.4% of those who had GF between 30 and 44.4 ml/min. There were no differences in the levels of Hb among those who received ESAs in the different stages, but there was a difference among those who did not receive ESAs. Conclusion: According to our observation, we conclude that anemia in the predialysis stage of the CKD is underdiagnosed and
undertreated. This explains why in patients who begin renal replacement therapy, signs of severe anemia are so common.
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