Anemia development and cardiovascular risk management in nonanemic stage 3 chronic kidney disease

摘要

BackgroundAim. 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 1878 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 2278 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 g24 h at one year versus 0.67 ± 1.0 g24 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 kgm2, 33.6% vs. 25.3%), target blood pressure (13080 mmHg, 21.0% vs. 27.9%), and proteinuria (0.8 ± 1.1 vs. 0.6 ± 0.9 gday). 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.