Association of kidney function with anemia - The Third National Health and Nutrition Examination Survey (1988-1994)
Association of kidney function with anemia - The Third National Health and Nutrition Examination Survey (1988-1994)
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DOI：
10.1001/archinte.162.12.1401
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发表时间：
2002-06-24
影响因子：
--
通讯作者：
Coresh, J
中科院分区：
文献类型：
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作者：
Astor, BC;Muntner, P;Coresh, J
背景：众所周知，肾衰竭会导致贫血，而贫血与心力衰竭和死亡率的高风险相关。在美国population.Methods：我们分析了15419名20岁及以上的参与者的基于人群的样本，第三次全国健康与营养检查调查，从1988年到1994年进行。较低的肾功能与较低的血红蛋白水平和较高的贫血患病率和严重程度有关，低于，但不高于，估计肾小球滤过率（GFR）为60 mL/min/1.73 m（2）。调整到60岁，男性（女性）血红蛋白水平预测中位数从14.9（13.5）g/dL，估计GFR为60 mL/min/1.73 m（2）至13.8在估计的GFR 30 mL/min/1.73 m（2）时，降至（12.2）g/dL，在估计的GFR 15 mL/min/1.73 m（2）时，降至12.0（10.3）g/dL。贫血患病率（男性血红蛋白水平< 12 g/dL，女性< 11 g/dL）从1%（95%置信区间，0.7%-2%），估计GFR为60 mL/min/1.73 m2至9%（95%置信区间，4%-19%），估计GFR为30 mL/min/1.73 m（2），（95%置信区间，11%-67%），男性估计GFR为15 mL/min/1.73 m2，（95%置信区间，30%-90%），女性的估计GFR为15 mL/min/1.73 m2。估计GFR为15 ~ 60 mL/min/1.73 m2的人群占总人群的4%，贫血患者占17%。结论：估计GFR低于60 mL/min/1.73 m2时，肾功能下降与美国成年人群贫血患病率升高密切相关。
Background: Kidney failure is known to cause anemia, which is associated with a higher risk of cardiac failure and mortality. The impact of milder decreases in kidney function on hemoglobin levels and anemia in the US population, however, is unknown.Methods: We analyzed a population-based sample of 15419 participants 20 years and older in the Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994.Results: Lower kidney function was associated with a lower hemoglobin level and a higher prevalence and severity of anemia below, but not above, an estimated glomerular filtration rate (GFR) of 60 mL/min per 1.73 m(2). Adjusted to the age of 60 years, the predicted median hemoglobin level among men (women) decreased from 14.9 (13.5) g/dL at an estimated GFR of 60 mL/min per 1.73 m(2) to 13.8 (12.2) g/dL at an estimated GFR of 30 mL/min per 1.73 m(2) and to 12.0 (10.3) g/dL at an estimated GFR of 15 mL/min per 1.73 m(2). The prevalence of anemia (hemoglobin level < 12 g/dL in men and < 11 g/dL in women) increased from 1% (95% confidence interval, 0.7%-2%) at an estimated GFR of 60 mL/min per 1.73 m(2) to 9% (95% confidence interval, 4%-19%) at an estimated GFR of 30 mL/min per 1.73 m(2) and to 33% (95% confidence interval, 11%-67%) at an estimated GFR of 15 mL/min per 1.73 m(2) among men and to 67% (95% confidence interval, 30%-90%) at an estimated GFR of 15 mL/min per 1.73 m(2) among women. An estimated GFR of 15 to 60 mL/min per 1.73 m(2) was present in 4% of the entire population and in 17% of the individuals with anemia.Conclusion: Below an estimated GFR of 60 mL/min per 1.73 m(2), lower kidney function is strongly associated with a higher prevalence of anemia among the US adult population.