Patients with anemia of chronic kidney disease (CKD) have a higher burden of comorbidities and lower kidney function than patients without anemia, according to new, real-world data from 4 countries presented at the virtual National Kidney Foundation 2021 Spring Clinical Meetings. Importantly, few receive anemia treatment.

The global cohort of 730,609 patients from DISCOVER CKD encompassed the Swedish Stockholm Creatinine Measurements (SCREAM) project, US TriNetX hospital-EMR, UK Clinical Practice Research Datalink (CPRD), Japanese Medical Data Vision (JMDV), US integrated Limited Claims and Electronic Health Records Database (LCED) databases, and US Dialysis Outcomes and Practice Patterns (DOPPS). Anemia, defined as a hemoglobin level less than 12 g/dL in women and less than 13 g/dL in men, was found in 32.5% to 41.0% of patients at baseline, of whom less than 2.5% received dialysis. All other patients had stage 3 to 5 CKD. The only exception was the US DOPPS cohort, which included only patients on hemodialysis (HD): 93.6% of these patients had anemia.

Compared with patients who did not have anemia, patients with anemia were 2 to 5 years older and had a median estimated glomerular filtration rate (eGFR) that was as much as 7 mL/min/1.73 m2 lower. In addition, higher proportions of patients with anemia had hypertension, heart failure, stroke, and type 2 diabetes, Eric Wittbrodt, PharmD, MPH, of AstraZeneca in Gaithersburg, Maryland, and colleagues reported.

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Few patients with nondialysis-dependent CKD and anemia received treatment, the investigators found. Only 6.1% or less underwent blood transfusion, 24% or less were prescribed oral iron (mostly in Sweden and the United Kingdom), 6.5% or less received intravenous iron, and 4.1% or less were administered erythropoiesis-stimulating agents (ESAs). In the US DOPPS cohort of HD patients, however, 82.8% and 93.5% of those with anemia and, notably, 78.8% and 66.0% of those without anemia received intravenous iron and ESAs, respectively.

“The lack of treated anemia may reflect multiple factors, including low recognition and/or the need for greater awareness of anemia; an absence of signs or symptoms of anemia; or limited access to safe and effective anemia treatments, particularly in early stages of CKD,” according to Dr Wittbrodt’s team

Disclosure: This clinical trial was supported by AstraZeneca. Please see the original reference for a full list of authors’ disclosures.


Wittbrodt E, Carrero JJ, James G, et al. Burden of anemia in patients with and without dialysis dependent chronic kidney disease: a report from the retrospective cohort from DISCOVER CKD. Presented at the virtual National Kidney Foundation 2021 Spring Clinical Meetings, April 6-10, 2021. Poster 182.