title: Renal impairment and anaemia in a population-based study of older people.
abstract: BACKGROUND
  Established renal failure is a known cause of anaemia. However, the association between more modest levels of renal impairment and anaemia is unclear.
  
  
  OBJECTIVE
  The aim of the present study was to investigate the association between mild renal impairment and anaemia in the general population.
  
  
  METHODS
  A population-based, cross-sectional study was conducted in the general community in an urban area of the Blue Mountains, just west of Sydney, Australia. The study included 3222 people aged > or =49 years (mean age 65 years). Serum creatinine and haemoglobin were measured using standard laboratory techniques. Creatinine clearance was estimated from serum creatinine, body weight, sex and age.
  
  
  RESULTS
  Two hundred and seventy subjects (8.4%) had serum creatinine levels > or =125 micromol/L and estimated -creatinine clearances were <0.84 mL/s (50 mL/min) in 894 subjects (27.7%) and <0.50 mL/s (30 mL/min) in 120 subjects (3.7%). There was a strong association between reduced renal function and anaemia. Compared to those with serum creatinine <125 micromol/L, the age-adjusted relative risk (RR) of anaemia in women (haemoglobin <12.0 g/dL) with serum creatinine > or =125 micromol/L was 5.5 (95% confidence interval (CI) 2.9-10.7) and the RR of anaemia in men (haemoglobin < 13.0 g/dL) was 3.1 (95% CI 1.6-6.0). Estimated -creatinine clearance <50 mL/min was associated with a three-fold increased risk of anaemia in women and a five-fold increased risk in men.
  
  
  CONCLUSIONS
  The results of the present study suggest that even modestly impaired renal function is associated with anaemia in older men and women. The possibility of renal impairment should be considered in the diagnosis and management of anaemia in people aged>50 years.
authors.affiliation: School of Public Health and Centre for Education and Research on Ageing, University of Sydney, Concord Hospital (C25), Concord, NSW 2139, Australia. bobc@health.usyd.edu.au
authors.forename: R G
authors.initials: RG
authors.lastname: Cumming
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
authors.forename: J C
authors.initials: JC
authors.lastname: Craig
authors.forename: J F
authors.initials: JF
authors.lastname: Knight
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology*; D001835:Body Weight; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
chemical_list: D006454:Hemoglobins; D003404:Creatinine