Fast Five Quiz: Chronic Kidney Disease Complications

A. Brent Alper, Jr, MD, MPH


June 05, 2020

Among patients with CKD, anemia begins early in the disease course and worsens as viable renal mass decreases and the glomerular filtration rate progressively decreases. Data from the National Health and Nutrition Examination Survey suggest that anemia is twice as prevalent in people with CKD (15.4%) as in the general population (7.6%), and more than 50% of patients with stage 5 CKD have anemia.

An increased risk for morbidity and mortality has been found among patients with CKD who have anemia. The association between anemia and mortality may be correlated to the severity of anemia.

Both absolute and functional iron deficiency are common among patients with CKD. Absolute iron deficiency refers to severely reduced or absent iron stores, whereas functional iron deficiency is defined by adequate iron stores but inadequate iron accessibility for integration into erythroid precursors, which results from increased levels of hepcidin.

Screening for anemia is an essential component of the evaluation for CKD. Notably, criteria used to define iron deficiency are different among patients with CKD versus those with normal renal function. According to criteria from the World Health Organization, anemia is defined as a hemoglobin level < 13 g/dL in men and < 12 g/dL in women. These same thresholds are recognized by 2012 Kidney Disease: Improving Global Outcomes guidelines.

Learn more about anemia and other complications of CKD.


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