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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Anemia development and cardiovascular risk management in nonanemic stage 3 chronic kidney disease
José Portolés1, Alberto Martinez Castelao, Jose Luis Gorriz
1Nephrology Service, Hospital Universitario Fundación Alcorcón, Avda. Villaviciosa 1, Alcorcón, Madrid, Spain. jmportoles@fhalcorcon.es
Insights
In early chronic kidney disease (CKD), 12.4% of patients developed anemia within one year. Diabetic CKD patients faced higher cardiovascular risks and poorer blood pressure control, indicating an overall unsatisfactory management of cardiovascular risk factors.
Area of Science:
- Nephrology
- Epidemiology
- Internal Medicine
Background:
- Limited data exists on anemia development in early-stage chronic kidney disease (CKD).
- Understanding renal anemia onset in non-anemic CKD patients is crucial for timely intervention.
Purpose of the Study:
- To analyze the onset of renal anemia in a cohort of initially non-anemic CKD patients.
- To assess the incidence of anemia in Stage 3 CKD patients over a one-year period.
Main Methods:
- Prospective, multicenter, epidemiological study over three years.
- Enrolled 432 patients (aged 18-78) with Stage 3 CKD, initially without anemia.
- Interim analysis of data collected during the first 12 months.
Main Results:
- 12.4% of CKD patients developed anemia within the first year.
- Diabetic CKD patients exhibited higher cardiovascular event prevalence (50.0% vs. 24.5%).
- Suboptimal control of cardiovascular risk factors was observed, particularly in diabetic patients (smoking, obesity, blood pressure, proteinuria).
Conclusions:
- Anemia developed in 12.4% of early CKD patients within one year.
- Diabetic patients with CKD present elevated cardiovascular risk and inadequate blood pressure management.
- Overall management of cardiovascular risk factors in this CKD cohort was unsatisfactory.
Background/Aim:
There is little information on the development of anemia in the early stages of chronic kidney disease. The aim of this study was to analyze the onset of renal anemia in a cohort of initially nonanemic chronic kidney disease patients followed up in nephrology clinics.
Methods:
This epidemiological, prospective, three-year, multicenter study enrolled patients aged 18-78 years with stage 3 chronic kidney disease without anemia. Interim analysis was performed on the data collected during the first 12 months.
Results:
The study included 432 patients, average age 63.6 years (range 22-78 years, 70% male). The main etiologies of chronic kidney disease were glomerular (11.6%), interstitial (10.4%), vascular (29.4%), and diabetic (16.9%). The percentages of patients with comorbidities were 33.8% diabetes (2.5% type 1), 69% dyslipidemia, and 93% hypertension. During the first year, 12.4% of patients developed anemia. The chronic kidney disease progression rate was low: proteinuria was 0.46 +/- 0.8 g/24 h at one year versus 0.67 +/- 1.0 g/24 h at baseline. Diabetic patients showed a greater prevalence of previous cardiovascular events (50.0% vs. 24.5%) and worse control of some modifiable cardiovascular risk factors: smoking (13.4% vs. 8.6%), obesity (BMI > 30 kg/m(2), 33.6% vs. 25.3%), target blood pressure (<130/80 mmHg, 21.0% vs. 27.9%), and proteinuria (0.8 +/- 1.1 vs. 0.6 +/- 0.9 g/day).
Conclusions:
After one year, 12.4% of patients developed anemia. Diabetic patients had a higher cardiovascular risk and limited blood pressure control. The overall control of cardiovascular risk was unsatisfactory.
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