Anemia development and cardiovascular risk management in nonanemic stage 3 chronic kidney disease.
OBJECTIVE
There is little information on the development of anemia in the early stages of chronic kidney disease. The aim of this study was to analyze the onset of renal anemia in a cohort of initially nonanemic chronic kidney disease patients followed up in nephrology clinics.


METHODS
This epidemiological, prospective, three-year, multicenter study enrolled patients aged 18-78 years with stage 3 chronic kidney disease without anemia. Interim analysis was performed on the data collected during the first 12 months.


RESULTS
The study included 432 patients, average age 63.6 years (range 22-78 years, 70% male). The main etiologies of chronic kidney disease were glomerular (11.6%), interstitial (10.4%), vascular (29.4%), and diabetic (16.9%). The percentages of patients with comorbidities were 33.8% diabetes (2.5% type 1), 69% dyslipidemia, and 93% hypertension. During the first year, 12.4% of patients developed anemia. The chronic kidney disease progression rate was low: proteinuria was 0.46 +/- 0.8 g/24 h at one year versus 0.67 +/- 1.0 g/24 h at baseline. Diabetic patients showed a greater prevalence of previous cardiovascular events (50.0% vs. 24.5%) and worse control of some modifiable cardiovascular risk factors: smoking (13.4% vs. 8.6%), obesity (BMI > 30 kg/m(2), 33.6% vs. 25.3%), target blood pressure (<130/80 mmHg, 21.0% vs. 27.9%), and proteinuria (0.8 +/- 1.1 vs. 0.6 +/- 0.9 g/day).


CONCLUSIONS
After one year, 12.4% of patients developed anemia. Diabetic patients had a higher cardiovascular risk and limited blood pressure control. The overall control of cardiovascular risk was unsatisfactory.
Portolés
José
J
Nephrology Service, Hospital Universitario Fundación Alcorcón, Avda. Villaviciosa 1, Alcorcón, Madrid, Spain. jmportoles@fhalcorcon.es
Castelao
Alberto Martinez
AM
Gorriz
Jose Luis
JL
Tato
Ana Maria
AM
de Alvaro
Fernando
F
D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D012107:Research Design; D013030:Spain / Q000453:epidemiology; D055815:Young Adult