Anemia in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) is associated with cardiovascular disease (CVD) and diminished quality of life, according to a new study of real-world practice in Europe.
Adrian Covic, MD, PhD, of Grigore T. Popa University of Medicine and Pharmacy in Romania, and colleagues reviewed data from 1993 patients with stage 3 to 4 CKD treated by 216 nephrologists and 26 endocrinologists from the Adelphi CKD Disease-Specific Programme in France, Germany, Italy, Spain, and the United Kingdom. Of these, 1223 (61.4%) had anemia, and and 698 (35%) were prescribed treatment for anemia. Anemia prevalence increased with CKD stage.
Results published in Advances in Therapy showed that anemic patients had a significantly higher mean number of cardiovascular comorbidities than those without anemia (1.27 vs 0.95).
In addition, anemic patients were 41% and 80% more likely than patients without anemia to have coronary heart disease and peripheral arterial disease, respectively. Having a cardiovascular condition was associated with significantly reduced QoL, work productivity, and activity, according to questionnaire responses from 867 patients. Anemic patients were particularly affected. For example, significantly more anemic patients were unemployed or retired. Older age itself correlates with more anemia, independent of renal function, based on previous research, the researchers noted. Anemic patients in this study tended to be older (age 66.5 vs 62.5 years).
The present findings corroborate some earlier research on CKD and CVD. “The current study goes further and shows that, in a CKD population, the presence of both anemia and CVD is associated with a lower QoL, as measured by several QoL measures,” Dr Covic and colleagues wrote.
The study did not assess ferritin and transferrin saturation, which is a limitation. Iron might be an important factor in the relationship between anemia, CVD, and CKD.
Covic A, Jackson J, Hadfield A, Pike J, Siriopol D. Real-world impact of cardiovascular disease and anemia on quality of life and productivity in patients with non-dialysis-dependent chronic kidney disease. Adv Ther. doi: 10.1007/s12325-017-0566-z