Prevalence of anaemia in adults with chronic kidney disease in a representative sample of the United States population: analysis of the 1999-2018 National Health and Nutrition Examination Survey

Lay Summary We used National Health and Nutritional Examination Survey (NHANES) data from 1999 to 2018 to determine how many adults (age >= 18 years) with non-dialysis-dependent chronic kidney disease (CKD) have anaemia (haemoglobin <12 g/dL for women; <13 g/dL for men) and severe anaemia (haemoglobin <10 g/dL). People with severe anaemia may be eligible for treatment with erythropoiesis-stimulating agents (ESAs), which stimulate the bone marrow to produce red blood cells. Among 51 163 eligible NHANES participants, 2926 (5.7%) had stage 3-5 CKD. Of these, 25.3% had anaemia and 1.9% had severe anaemia. The odds of severe anaemia were greater for participants with CKD stage >= 3B (more severe) versus stage 3A (less severe) and for non-Hispanic Black participants than those of other races or ethnicities. Our study found that one-quarter of people with stage 3-5 CKD in the USA have anaemia and similar to 2% may be eligible for ESA treatment. Background Population-based estimates of anaemia prevalence in patients with chronic kidney disease (CKD) vary, and data on the prevalence of severe anaemia of CKD are limited. This study examined the prevalence of anaemia and anaemia eligible for erythropoiesis-stimulating agent (ESA) treatment in patients with CKD in the USA. Methods National Health and Nutrition Examination Survey (NHANES) data from 1999-2000 to 2017-18 were used to determine the prevalence of diagnosed anaemia (haemoglobin <12 g/dL in women; <13 g/dL in men) and anaemia eligible for ESA treatment (haemoglobin <10 g/dL) in survey participants aged >= 18 years with stage 3-5 non-dialysis-dependent CKD (estimated glomerular filtration rate <60 mL/min/1.73 m(2)). The study objectives were to (i) obtain a more recent estimate of anaemia prevalence in patients with non-dialysis-dependent CKD and (ii) examine the characteristics of individuals with CKD and haemoglobin Results Of 51 163 eligible NHANES participants, 2926 (5.7%) with stage 3-5 CKD were included. In all participants, the weighted prevalences of anaemia and haemoglobin <10 g/dL were 25.3% and 1.9%, respectively. Mean haemoglobin levels decreased numerically between 1999 and 2012 and remained stable thereafter. The prevalence of anaemia and haemoglobin Conclusions In our analysis, approximately 25% of individuals with stage 3-5 CKD in the USA had anaemia and approximately 2% had anaemia eligible for ESA treatment.