Pages: 8-15

Abstract

Background: Anaemia is associated with adverse outcomes in patients withchronic kidney diseases (CKD). There is scarcity of published literature regarding prevalence, risk factors and management of anaemia in CKD patients from Pakistan. Objective: To evaluate the prevalence, risk factors and management of anaemia in non-dialysis CKD (CKD-ND) patients. Methodology: This was a cross-sectional study conducted at Balochistan Institute of Nephrology-Urology Quetta (BINUQ), Pakistan. Eligible CKD-ND patients who were visiting the outpatient department of BINUQ and gave consent to participate in the study were included. A purpose developed data collection form was used to collect patients’ socio-demographic, clinical and laboratory data. Anaemia was defined as haemoglobin level of <13 g/dl in males and <12g/dl in females. Data was analysed by SPSS 20. Multivariate binary logistic regression analysis was used to identify factors associated with the presence of anaemia. A p-value <0.05 was considered statistically significant. Results: A total of 220 patients were included in the final analysis. Mean age of the patients was 46.78 +18 years.  Majority of them were males (62.3%), belonged to the age group 46-65 years (30.5%) and suffered from CKD stage-5 (75.9%). A total of 177 (80.5%) patients suffered from anaemia. In multivariate analysis, only CKD stage-5 had statistically significant association with the presence of anaemia (OR=4.521, p-value=0.001). Among 177 anaemic patients, only 75.7%received anti-anaemic treatment. Among them, 98.5% received blood transfusion, 6.7% folic acid, 2.9% iron and 2.2% received vitamin B₁₂. Conclusion: Despite its high prevalence, a notable proportion (24.3%) of anaemic patients was not managed for anaemia. Guidelines preferred iron supplements and erythropoietin stimulating agents (ESAs) were extremely underutilized. Almost all(98.5%)anaemic patients received guidelines discouraged blood transfusion for anaemia management.