Clinical Characteristics And Correlative Factors Of Anemia At Stages 3?5 Chronic Kidney Disease Non-hemodialysis Patients

Objective: To analyze the clinical characteristics and correlative factors of anemia at stages 3~5 chronic kidney disease non-hemodialysis patients.Methods: We retrospectively analyzed the clinical data of 319 non-hemodialysis patients at stages 3~5 chronic kidney disease admitted to the department of nephrology in the Union Hospital of Fujian Medical University from June 2016 to June 2018.All patients met the diagnostic criteria for CKD,and the diagnostic criteria of anemia refer to the third edition “internal medicine” edited by chen Wang et al.According to the e GFR,319 patients were divided into three groups(CKD3,CKD4,CKD5).According to the hemoglobin level,patients were divided into anemia group and non-anemia group.Results: 1.Among the 319 patients,207(64.89%)were males and 112(35.11%)were females,the ratio of male to female was 1.85:1.The youngest was 19 years old,the oldest was 91 years old,and the average age was(57.38±16.50)years old.Among the 319 patients,the cases of CKD3 were 38(11.91%),the cases of CKD4 were 70(21.94%),the cases of CKD5 were 211(66.15%).2.Etiology constituted of chronic kidney disease as follows: 151 cases of chronic nephritis(47.34%),85 cases of diabetic kidney disease(26.65%),43 cases of hypertensive nephropathy(13.48%),8 cases of gouty nephropathy(2.51%),7 cases of polycystic kidney(2.19%)and 7 cases of obstructive nephropathy(2.19%),2 cases of HBV-associated glomerulonephritis(0.63%)and 2 cases of lupus nephritis(0.63%),14 cases of the other reasons(4.38%).Among the 319 patients,211 cases were associated with hypoalbuminemia(68.24%),199 cases were with hyperphosphatemia(68.24%),54 cases were associated with hypocalcemia(16.93%),and 234 cases were with hyperparathyroidism(73.35%).Albumin,corrected calcium,phosphorus,i PTH and Scr levels were significantly different in patients at different CKD stages(P<0.05).Serum albumin at CKD5 was lower than that at CKD3.The corrected calcium at CKD4 was higher than that at CKD5,and at CKD3 was higher than that at CKD5.Serum phosphorus at both CKD4 and CKD3 was lower than that at CKD5,and the above indexes were statistically different between the groups(P<0.05).The incidence of anemia at stages 3 ~ 5 CKD was 55.26%,81.43% and 97.16%,respectively.The difference of anemia incidence between each groups was statistically significant(P<0.001).3.In the univariate analysis of anemia,age,infection rate,blood phosphorus,Scr and i PTH in the anemia group were all higher than those in the non-anemia group.However,serum albumin and corrected serum calcium in the anemia group were all lower than those in non-anemia group.The difference between two groups was statistically significant(P<0.05).Logistic regression analaysis showed that hypoalbuminemia and infection were the risk factors for anemia at stages 3~5 chronic kidney disease non-hemodialysis patients.Conclusion: 1.Chronic nephritis was the most common cause of CKD at stages 3~5(47.34%),followed by diabetic kidney disease(26.65%)and hypertensive nephropathy(13.48%).2.With the development of CKD,serum albumin gradually decreased,while serum phosphorus and i PTH gradually increased.3.The prevalence of anemia increased significantly as CKD progresses.hypoalbuminemia and infection were independent risk factors for anemia at stages 3-5 chronic kidney disease non-hemodialysis patients.