Prevalence of anemia in the nursing home: contribution of chronic kidney disease.
OBJECTIVE
To assess the independent contribution of chronic kidney disease (CKD) and age to anemia in older nursing home residents.


METHODS
Retrospective.


METHODS
Skilled nursing facility.


METHODS
Nursing home residents with records in the Beverly Healthcare Data Warehouse who were admitted to a nursing home between January 1, 2002, and December 31, 2003; were alive as of January 31, 2004; and had hemoglobin and serum creatinine (SCr) values available for analysis.


METHODS
Prevalence of anemia (hemoglobin <13 g/dL for men and <12 g/dL for women) and CKD (estimated glomerular filtration rate <60 mL/min per 1.73 m(2), according to Modification of Diet in Renal Disease criteria) and the contribution of CKD and age to the prevalence of anemia.


RESULTS
Six thousand two hundred resident records were analyzed (70% female, 85% Caucasian). Overall, 59.6% of residents were anemic, and 43.1% had CKD, and residents with CKD were more likely to have anemia (64.9% with vs 55.7% without CKD; odds ratio (OR)=1.47, 95% confidence interval (CI)=1.33-1.63). Although older age was associated with lower hemoglobin values primarily in residents without CKD (Spearman rank correlation coefficient (r)=-0.10, P<.001), age had no association with hemoglobin in CKD (Spearman r=0.01, P=.60). The greater risk of anemia in the presence of CKD persisted in each age category (OR=2.07, 95% CI=1.53-2.80, aged 65-74; OR=1.44, 95% CI=1.21-1.70, aged 75-84; and OR=1.35, 95% CI=1.15-1.57, aged > or =85).


CONCLUSIONS
Overall, these results suggest that CKD contributes more strongly than older age to the high prevalence of anemia in older nursing home residents.
Robinson
Bruce
B
Department of Geriatrics, Florida State University College of Medicine, Sarasota, Florida, USA. Bruce-Robinson@smh.com
Artz
Andrew S
AS
Culleton
Bruce
B
Critchlow
Cathy
C
Sciarra
Angela
A
Audhya
Paul
P
D000368:Aged; D000740:Anemia / Q000145:classification / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005919:Glomerular Filtration Rate; D006454:Hemoglobins; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D015337:Multicenter Studies as Topic; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
D006454:Hemoglobins