title: Risk for anemia in pediatric chronic kidney disease patients: a report of NAPRTCS.
abstract: Previous studies in children with chronic kidney disease (CKD) have identified low hemoglobin as a risk factor for poor outcomes. A retrospective review of the North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) CKD registry was performed to identify the prevalence of and risk factors for anemia among children with stage 3 CKD, including both patients with low hemoglobin and those whose hemoglobin normalized with an erythropoiesis-stimulating agent (ESA). At enrollment, 2,792 patients had stage 3 CKD. Mean age was 9.5 (+/-0.11) years, 62.1% were male, 61.3% were white, and 43.7% had structural/urologic disease. Among 1,640 of those patients with 12 month follow-up data available for multivariate analysis, 73% met the criteria for anemia. Multivariate logistic regression analysis identifying risk factors for anemia at the 12-month follow-up revealed that, after controlling for estimated glomerular filtration rate, age >2 years, male sex, earlier era of study entry, and prescription of anti-hypertensive medications are associated with an increased risk for anemia at 12 months. In addition, multivariate Cox proportional hazards regression analysis revealed that when patients with ESA-corrected hemoglobin are included in the definition, anemia is not associated with increased risk of progression to end stage renal disease (dialysis initiation or transplantation).
authors.affiliation: Division of Pediatric Nephrology, Johns Hopkins University, 200 N Wolfe St, Baltimore, MD 21287, USA. matkins3@jhmi.edu
authors.forename: Meredith A
authors.initials: MA
authors.lastname: Atkinson
authors.forename: Karen
authors.initials: K
authors.lastname: Martz
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Warady
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Neu
mesh_terms: D000293:Adolescent; D000740:Anemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D005260:Female; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D016015:Logistic Models; D008297:Male; D009656:North America / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D016016:Proportional Hazards Models; D012042:Registries; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D006397:Hematinics
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