The Analysis To The Incidence And Relevant Factors Of Anemia In Patients With Chronic Kidney Disease

Objective To analyze the incidence of anemia in the patients with GFR﹤60ml/minof chronic kidney disease（CKD）and its relevant influencing factors.Methods A retrospective analysis of105CKD inpatients in the Department ofNephrology of the First Affiliated Hospital of Anhui College of Traditional ChineseMedicine from January2007to February2009was conducted.105cases CKD patientsare in line with the provisions of chronic kidney disease clinical practice guidelinesdrawn up in2002by the American Kidney Foundation (National Kidney Foundation，NKF) K/DOQI chronic kidney disease diagnostic criteria. Anemia diagnostic criteria ison the basis of Zai-Ying Lu et al[13]edited " Internal Medicine".70males and35females，aged18to84years old，the average age of52.98±16.86years. In the105cases CKDⅢ~Ⅴpatients，the number of cases of CKDⅢ18cases，CKDⅣ28cases，CKDⅣ59cases. Etiology constituted of chronic kidney disease as follows：The chronic nephritis51cases accounted for48.57%，the hypertensive nephropathy41cases accounted for39.05%，gouty nephropathy three cases accounted for2.86%，three cases of polycystic kidney disease，accounting for2.86%，Six cases of diabeticnephropathy accounted for5.71%，the obstructive nephropathy1cases accounted for0.95%，Exclude the following circumstances：receive renal replacement therapy andthe use of erythropoietin treatment，and age <18years of age，renal abrupt decline.Record of the patient’s age，sex，weight，routine blood test，urea nitrogen (BUN)，creatinine (SCr)，uric acid (UA)，albumin (ALB)，calcium，iron，phosphorus andother indicators respectively. GFR as the clinical evaluation of renal function indicators is calculated with MDRD formula.Results In the105patients with CKD in stageⅢ~Ⅴ，CKDⅢincidence ofanemia was50%，CKDⅣincidence of anemia was75%，CKDⅤincidence ofanemia was91.5%. By X2test，differences between groups were statisticallysignificant (χ~2=15.461，P<0.01). In the patients， the level of GFR，BUN，SCr，Phosphorus had significant difference(P <0.01)，and then the CKDⅢ~ⅤperiodGFR、BUN、SCr、Phosphorus levels for pairwise comparison respectively，the levelof Phosphorus between the patients in stage Ⅲandthe patients in stage Ⅳhad nosignificant difference (Z=-1.464， P=0.143）， while other comparisons had significantdifference (P<0.01)，including there were significant differences（P<0.01） in serumPhosphorus levels comparison between the patient of CKDⅢandⅤperiod andbetween the patient of CKDⅣandⅤperiod respectively，Moreover，In thepatients，the level of Hb、UA、calcium had significant difference (P <0.05). Hb levelas the dependent variable，uric acid，albumin，calcium，iron and other indicatorsas independent variables，conduct multivariate regression analysis，the results show asignificantly positive correlation of hemoglobin level was found with serum albuminand calcium level (P<0.01)，uric acid and hemoglobin appear negative correlation.Seen by standardized partial regression coefficient the affect strength of hemoglobin isby the order of calcium，albumin，uric acid.Conclusions The incidence of anemia in patients with chronic kidney disease wasassociated with the stage of CKD. The serum albumin and calcium level affect theincidence of anemia in patients with chronic kidney disease.