Investigation Of Anemia And Dyslipidemia In Chronic Kidney Disease Inpatients

Objective:This study is conducted to investigate the cause,CKD stages,dialysis modalities as well as the prevalence,treatment rates and control rates of anemia and dyslipidemia in patients with chronic kidney disease(CKD),in order to provide those patients with more standardized treatment and management.Methods:This study used a retrospective survey method.We investigated all the inpatients with CKD who were admitted in the department of nephrology at the First Affiliated Hospital of Soochow University from January 2013 to November 2016.The basic information we collected includes patients' names,sex,age,primarydisease,dialysismodalities,history of hypertension and diabetes,as well as the level of hemoglobin(Hb),serum triglyceride,total cholesterol,low-density lipoprotein,high-density lipoprotein,serum albumin,etc.We also recorded the treatment patients accepted to improve anemia and dyslipidemia.Theinformation was also collected in the table of Excel software and analyzed by SPSS statistical software.Results:(1)Basics:This study included 2464 CKD patients,including 1336 male patients(54.22%)and 1128 female patients(45.78%),with the male-to-female ratio of 1.18:1.Primary glomerulonephritis,hypertensive nephropathy and diabetic nephropathy were the most common cause of CKD and the number of these patients was 1413(57.35%),326(12.91%)and 318(12.91%).The proportion of patients from CKD 1 stage to 5 stage was 24.93%,13.12%,15.94%,9.69% and 36.33%.Among CKD 5 stage patients,41.28% of them were non-dialysis patients,48.59% of them were peritoneal dialysis patients and hemodialysis patients accounted for 10.13%.(2)There were 1504 CKD patients with anemia.The prevalence of anemia in CKD patients was 61.04% and the average Hb level was 97.39±18.29g/L.Among them,1026 patients(68.22%)were mild anemia,433(28.79%)patients were moderate anemia and 45 patients(3.99%)were severe anemia.The prevalence rate grows with advantage of CKD stages and the growth of age.Among CKD 5 stage patients,the prevalence rate was 96.19% in non-dialysis ones,94.21% in peritoneal ones and 86.67% in hemodialysis ones.The overall rate of anemia treatment in CKD patients was 65.76% and the control rate after treatment was 71.03%.The EPO treatment rate was 43.15% and the iron treatment rate was 65.63%.With the advantage of CKD stages and anemia degree,there was a growth in the EPO treatment rate.With the advantage of anemia degree,the iron treatment rate and the combined treatment of EPO and iron showed an obvious increase.(3)Age,diabetes,serumcreatinine,high-density cholesterol,low-density cholesterol,serum albumin and hig-sensitivity C-reactive protein(hs-CRP)are related factors of anemia in CKD patients.(4)There were 1496 patients suffering from dyslipidemia and the prevalence rate was 60.71%.Among them,hypercholesterolemia,hypertriglyceridemia,mixed dyslipidemia and hypo high-density lipoprotein cholesterolemia were 8.50%,18.64%,9.40% and 24.56%.The prevalence of dyslipidemia increased with the worsening of renal function in CKD 1-2 stage and it decreased to the lowest point in CKD 3 stage patients while it increased in CKD 4-5 stage.The proportion of dyslipidemia in CKD 5 stage patients was 63.78%,which was the highest among all the CKD stages.The prevalence of hypercholesterolemia was high among CKD1 stage patients and decresed among CKD2-5 stages.Hypo high-density lipoprotein cholesterolemia was the most common type of dyslipidemia among CKD4-5 stage patients.The prevalence of dyslipidemia among non-dialysis,peritoneal dialysis and hemodialysis patients in CKD5 stage was 63.30%,63.89% and 57.78%.(5)In all patients with dyslipidemia,the treatment rate was 40.64%.The treatment rate of patients with mild to moderate renal dysfunction was 42.42%,while the rate of severe damage patients was 16.74% and the control rate were 22.92% and 14.06%.(6)Multiple linear regression analysis of dyslipidemia revealed a correlation between the level of lipid in blood and BMI,e GFR,Hb,24 hour urine protein level,fastingglucose,hs-CRP,serumalbumin,etc.Conclusion:(1)It is common that patient with CKD also suffering from anemia.The prevalence of anemia gradually increases with the renal function decrease.At the early stage of CKD,some patients have had mild anemia yet while almost all the CKD5 stage patients have different degree of anemia.(2)The treatment rate of anemia is 65.76% and the control rate is 71.03%.(3)Over half of the patients with CKD have dyslipidemia.CKD 1 stage patients are mainly charactized by hypercholesterolemia,hypertriglyceridemia and mixed dyslipidemia.CKD2-5 stage patients are mainly charactized by hypo high-density lipoprotein cholesterolemia and hypertriglyceridemia.(4)There are correlation between the level of lipid in blood and BMI,e GFR,Hb,24 hour urine protein level,fasting glucose,hs-CRP,serum albumin,etc.