Hemoglobin Differences by Race in Children With CKD
Hemoglobin Differences by Race in Children With CKD
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DOI：
10.1053/j.ajkd.2009.12.040
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发表时间：
2010-06-01
影响因子：
13.2
通讯作者：
Furth, Susan L.
中科院分区：
文献类型：
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作者：
Atkinson, Meredith A.;Pierce, Christopher B.;Furth, Susan L.
背景资料：慢性肾脏病（CKD）患者的贫血患病率存在种族差异，但这些差异在儿童中尚未得到很好的描述。研究设计：队列研究，横断面分析。设置和参与者：儿童慢性肾脏病（CKiD）研究是一项多中心的前瞻性队列研究，研究对象为轻度至中度CKD儿童。这项分析包括429名非裔美国人或白色种族的儿童。预测因素：种族。结果和测量：这项研究检查了种族与血红蛋白水平的关系。多元线性回归和广义伽马建模技术被用来描述种族和血红蛋白level.Results之间的关联：队列的79%是白色，21%是非洲裔美国人。血红蛋白水平中位数和红细胞生成刺激剂使用频率均无种族差异。在多变量分析中，较低水平的碘海醇测量的肾小球滤过率、非裔美国人种族和肾小球疾病（与非肾小球疾病相比）作为CKD的潜在原因与血红蛋白水平降低独立相关;与肾小球滤过率和CKD诊断无关，非裔美国儿童的平均血红蛋白水平为0.6 g/dL（95% CI，-0.9至-0.2 g/dL）低于白色儿童。广义伽马建模显示，当从高到低的整体血红蛋白水平distributions.Limitations：横断面分析不能建立因果关系，并为所有patients.Conclusions：非裔美国人相比，白色儿童有较低的血红蛋白值在CKD的独立的根本原因CKD。血红蛋白水平的这些种族差异似乎在该人群中血红蛋白水平分布的低端增加。美国肾脏病杂志55：1009 - 1017。(C)2010年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
Background: There are known racial disparities in the prevalence of anemia in adults with chronic kidney disease (CKD), but these differences have not been well described in children.Study Design: Cohort study, cross-sectional analysis.Setting & Participants: The Chronic Kidney Disease in Children (CKiD) Study is a multicenter prospective cohort study of children with mild to moderate CKD. This analysis included 429 children of African American or white race.Predictor: Race.Outcomes & Measurements: This study examined the association of race with hemoglobin level. Both multiple linear regression and generalized gamma modeling techniques were used to characterize the association between race and hemoglobin level.Results: 79% of the cohort was white, 21% was African American. Neither median hemoglobin level nor frequency of erythropoiesis-stimulating agent use differed by race. In multivariate analysis, lower levels of iohexol-measured glomerular filtration rate, African American race, and glomerular disease (vs nonglomerular disease) as the underlying cause of CKD were independently associated with decreased hemoglobin levels; independent of glomerular filtration rate and CKD diagnosis, African American children had average hemoglobin levels that were 0.6 g/dL (95% CI, -0.9 to -0.2 g/dL) lower than those of white children. Generalized gamma modeling showed that differences in hemoglobin levels observed by race become more pronounced when moving from high to low in the overall hemoglobin level distribution.Limitations: Cross-sectional analysis cannot establish causality, and data for iron stores were not available for all patients.Conclusions: African American compared with white children have lower hemoglobin values in CKD independent of the underlying cause of CKD. These racial differences in hemoglobin levels appear to increase at the lower end of the hemoglobin level distribution in this population. Am J Kidney Dis 55: 1009-1017. (C) 2010 by the National Kidney Foundation, Inc.