Factors Related to the Presence of Anemia in Patients with Chronic Kidney Disease in Hemodialysis

Abstract

Introduction: The prevalence of anemia in Chronic Kidney Disease (CKD) is high. However, little is known about the factors related to anemia in patients with chronic Hemodialysis (HD) in Mexico. Material and Methods: A cross-sectional study was conducted in adult patients with CKD undergoing HD in the northern area of Mexico City treated at the Mexican Institute of Social Security. Hemoglobin (Hb) and Hematocrit (Htc) levels, as well as clinical and biochemical factors associated with anemia, were evaluated. Results: Data was collected from 747 patients, obtaining a mean hemoglobin of 9.7 g/dl (IQR 8.4-10.9 g/dl). The group was divided into two using Hb <10.0 g/dl and >10.0 g/dl as cutoff limits. Fifty six percent of the patients had hemoglobin =10.0 g/dl. Hb level <10.0 g/dl were associated with DM (OR 1.49, IC 95% 1.06-2.10, p=0.001), hyperphosphatemia (OR 1.69, IC 95% 1.21-2.28, p=0.001), high calcium-phosphate product (OR 1.43, IC 95% 1.01-2.03, p=0.040) and iron deficiency (OR 1.95, IC 95% 1.38-2.75, p=0.001). Glomerulopathies (OR 0.44, IC 95% 0.22-0.90, p=0.026), female gender (OR 0.55, IC 95% 0.40-0.074, p=0.001) and erythropoietin administration (OR 0.57, IC 95% 0.39-0.82, p=0.002) were associated with hemoglobin ≥10 g/dl. Conclusion: The factors associated with Hb <10.0 g/dl were mineral-bone metabolism disorders and iron deficiency. The periodic evaluation of qualityof- care indicators of HD treatment, such anemia, are necessary to detect improvement opportunities.