Document Detail


Anemia and cardiovascular disease, hospitalization, end stage renal disease, and death in older patients with chronic kidney disease.
MedLine Citation:
PMID:  16142575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Large observational studies examining the association between anemia and "hard" clinical outcomes are rare in patients with chronic kidney disease (CKD). METHODS: We used the General Medicare 5% Denominator Files to identify patients aged 67 years or more with CKD on December 31, 1999. Outcomes in the ensuing 2 years were compared in patients with and those without anemia (entry period, 1998-1999; follow-up period, 2000-2001). RESULTS: Of 41,522 CKD patients identified, 49.0% had claims of anemia diagnosis. The factors associated (p< 0.0001) with anemia included older age, female gender, black race, and all 10 comorbid conditions studied; adjusted odds ratios (ORs) exceeded 1.5 for age 80 years old or older (OR, 1.54 compared to <70 years), for black race (OR, 1.52), and for co-existing diagnoses of congestive heart failure (OR, 1.64), gastrointestinal bleeding (OR, 3.65), and liver disease (OR, 2.16). During the follow-up period, outcome event rates (expressed per 1000 patient-years) were as follows: renal replacement therapy, 23.5; death, 186.4; congestive heart failure, 390.0; atherosclerotic vascular disease, 410.5; and first hospitalization, 552.6. Using proportional hazards modeling, the presence of anemia was associated (p < 0.0001) with the following adjusted hazards ratios: atherosclerotic vascular disease, 1.09; congestive heart failure, 1.14; renal replacement therapy, 2.61 and death, 1.40. CONCLUSION: A diagnosis of anemia is present in nearly half of all patients with CKD, aged 67 years or more, a group at very high risk of cardiovascular disease, hospitalization, end-stage renal disease, and death. Anemia is associated with each of these events.
Authors:
Shuling Li; Robert N Foley; Allan J Collins
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International urology and nephrology     Volume:  37     ISSN:  0301-1623     ISO Abbreviation:  Int Urol Nephrol     Publication Date:  2005  
Date Detail:
Created Date:  2005-09-05     Completed Date:  2006-04-10     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  0262521     Medline TA:  Int Urol Nephrol     Country:  Hungary    
Other Details:
Languages:  eng     Pagination:  395-402     Citation Subset:  IM    
Affiliation:
Nephrology Analytical Services, Minneapolis Medical Research Foundation, Minneapolis, MN 55404, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anemia / etiology*
Chronic Disease
Cohort Studies
Female
Follow-Up Studies
Hospitalization*
Humans
Kidney Diseases / complications*,  mortality,  therapy
Kidney Failure, Chronic / etiology*
Male
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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