PLoS ONE (Jan 2020)

Prevalence of anemia in patients with chronic kidney disease in Japan: A nationwide, cross-sectional cohort study using data from the Japan Chronic Kidney Disease Database (J-CKD-DB).

  • Tadashi Sofue,
  • Naoki Nakagawa,
  • Eiichiro Kanda,
  • Hajime Nagasu,
  • Kunihiro Matsushita,
  • Masaomi Nangaku,
  • Shoichi Maruyama,
  • Takashi Wada,
  • Yoshio Terada,
  • Kunihiro Yamagata,
  • Ichiei Narita,
  • Motoko Yanagita,
  • Hitoshi Sugiyama,
  • Takashi Shigematsu,
  • Takafumi Ito,
  • Kouichi Tamura,
  • Yoshitaka Isaka,
  • Hirokazu Okada,
  • Kazuhiko Tsuruya,
  • Hitoshi Yokoyama,
  • Naoki Nakashima,
  • Hiromi Kataoka,
  • Kazuhiko Ohe,
  • Mihoko Okada,
  • Naoki Kashihara

DOI
https://doi.org/10.1371/journal.pone.0236132
Journal volume & issue
Vol. 15, no. 7
p. e0236132

Abstract

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BackgroundThe Japan Chronic Kidney Disease Database (J-CKD-DB) is a nationwide clinical database of patients with chronic kidney disease (CKD) based on electronic health records. The objective of this study was to assess the prevalence of anemia and the utilization rate of erythropoiesis-stimulating agents (ESAs) in Japanese patients with CKD.MethodsIn total, 31,082 adult outpatients with estimated glomerular filtration rates of 5-60 ml/min/1.73 m2 in seven university hospitals were included this analysis. The proportions of patients with CKD stages G3b, G4, and G5 were 23.5%, 7.6%, and 3.1%, respectively.ResultsThe mean (standard deviation) hemoglobin level of male patients was 13.6 (1.9) g/dl, which was significantly higher than the mean hemoglobin level of female patients (12.4 (1.6) g/dl). The mean (standard deviation) hemoglobin levels were 11.4 (2.1) g/dl in patients with CKD stage G4 and 11.2 (1.8) g/dl in patients with CKD stage G5. The prevalences of anemia were 40.1% in patients with CKD stage G4 and 60.3% in patients with CKD stage G5. Logistic regression analysis showed that diagnoses of CKD stage G3b (adjusted odds ratio [95% confidence interval]: 2.32 [2.09-2.58]), G4 (5.50 [4.80-6.31]), and G5 (9.75 [8.13-11.7]) were associated with increased prevalence of anemia. The utilization rates of ESAs were 7.9% in patients with CKD stage G4 and 22.4% in patients with CKD stage G5.ConclusionsWe determined the prevalence of anemia and utilization rate of ESAs in Japanese patients with CKD using data from a nationwide cohort study.