Iron Deficiency Anemia in Patients with Chronic Renal Insufficiency at Tertiary Care Hospital in Northern Punjab

Iron Deficiency Anemia in Chronic Renal Disease

Authors

  • Muhammad Shuaib Department of General Medicine, Mohi-ud-Din Islamic Medical College, Mirpur, Pakistan
  • Muhammad Imran Department of General Medicine, Mohi-ud-Din Islamic Medical College, Mirpur, Pakistan
  • Hasan Akbar Khan Department of Biochemistry, Al-Aleem Medical College, Lahore, Pakistan
  • Muhammad Ikram ul Haq Department of Medicine, Niazi Medical and Dental College, Sargodha, Pakistan
  • Hafiz Muhammad Zubair Department of Medicine, KRL Hospital, Islamabad, Pakistan
  • Muhammad Irfan Department of Peads Medicine, Mohi-ud-Din Islamic Medical College, Mirpur, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i05.1542

Keywords:

Anemia, Renal Insufficiency, Creatinine, Glomerular Filtration, Ferritin

Abstract

Anemia is a frequently encountered complication of chronic kidney disease (CKD) leading to worse outcomes in terms of quality of life and premature death. However, the current prevalence of iron deficiency anemia (IDA) in CKD is understudied in Pakistan. Objective: To assess the frequency of IDA in patients with CKD at Bewal International Hospital, Gujar Khan, Pakistan. Methods: A cross-sectional was executed at the Department of Nephrology, Bewal International Hospital, Pakistan from January 1, 2022, to June 30, 2022. The study comprised 97 patients aged >13 years of either gender having CKD (GFR <60 ml/min/1.73m²) for at least 90 days. All patients were tested for serum creatinine, ferritin, and hemoglobin levels. IDA was considered if hemoglobin was ≤12 mg/dL in women and ≤13 mg/dL in men. Results: Among 97 patients, there were 57(58.7%) males and 40(41.3%) females. The mean age was 51.23 ± 12.99 years while the mean disease duration was 6.01 ± 1.610 years. 57(58.7%) patients had IDA. IDA was more frequent in women with CKD (67.5%), compared to men (52.64%). However, this association was statically insignificant (p>0.05). When data was stratified, a substantial association was found between IDA and the stage of CKD (p=0.007). There was no significant association between IDA and disease duration (p>0.05).  Conclusions: It was concluded that anemia is common in CKD patients, with a high prevalence in females. Stage 3–5 CKD is significantly associated with developing iron deficiency anemia. Early identification and timely management can avoid unfavorable outcomes in these patients.

Author Biographies

Muhammad Shuaib, Department of General Medicine, Mohi-ud-Din Islamic Medical College, Mirpur, Pakistan

 

 

Muhammad Imran, Department of General Medicine, Mohi-ud-Din Islamic Medical College, Mirpur, Pakistan

 

 

Muhammad Ikram ul Haq, Department of Medicine, Niazi Medical and Dental College, Sargodha, Pakistan

 

 

Hafiz Muhammad Zubair, Department of Medicine, KRL Hospital, Islamabad, Pakistan

 

 

Muhammad Irfan, Department of Peads Medicine, Mohi-ud-Din Islamic Medical College, Mirpur, Pakistan

 

 

References

Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney international Supplements. 2022 Apr; 12(1): 7-11. doi: 10.1016/j.kisu.2021.11.003. DOI: https://doi.org/10.1016/j.kisu.2021.11.003

Liyanage T, Toyama T, Hockham C, Ninomiya T, Perkovic V, Woodward M et al. Prevalence of chronic kidney disease in Asia: a systematic review and analysis. BMJ Global Health. 2022 Jan; 7(1): e007525. doi: 10.1136/bmjgh-2021-007525. DOI: https://doi.org/10.1136/bmjgh-2021-007525

Hasan M, Sutradhar I, Gupta RD, Sarker M. Prevalence of chronic kidney disease in South Asia: a systematic review. BMC Nephrology. 2018 Dec; 19: 1-2. doi: 10.1186/s12882-018-1072-5. DOI: https://doi.org/10.1186/s12882-018-1072-5

Imtiaz S and Alam A. Epidemiology and demography of Chronic Kidney Disease in Pakistan-A review of Pakistani literature. Pakistan Journal of Kidney Diseases. 2023 Mar; 7(1): 2-7. doi: 10.53778/pjkd71209. DOI: https://doi.org/10.53778/pjkd71209

Ahmed J, Azhar S, ul Haq N, Hussain S, Stájer A, Urbán E et al. Awareness of chronic kidney disease, medication, and laboratory investigation among nephrology and urology patients of Quetta, Pakistan. International Journal of Environmental Research and Public Health. 2022; 19(9): 5015. doi: 10.3390/ijerph19095015. DOI: https://doi.org/10.3390/ijerph19095015

Hain D, Bednarski D, Cahill M, Dix A, Foote B, Haras MS et al. Iron Deficiency Anemia in CKD: A Narrative Review for the Kidney Care Team. Kidney Medicine. 2023 May: 100677. doi: 10.1016/j.xkme.2023.100677. DOI: https://doi.org/10.1016/j.xkme.2023.100677

Bishaw F, Woldemariam MB, Mekonen G, Birhanu B, Abebe A. Prevalence of anemia and its predictors among patients with chronic kidney disease admitted to a teaching hospital in Ethiopia: A hospital-based cross-sectional study. Medicine. 2023 Feb; 102(6): e31797. doi: 10.1097/MD.0000000000031797. DOI: https://doi.org/10.1097/MD.0000000000031797

Kovesdy CP, Davis JR, Duling I, Little DJ. 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. Clinical Kidney Journal. 2023 Feb; 16(2): 303-11. doi: 10.1093/ckj/sfac240. DOI: https://doi.org/10.1093/ckj/sfac240

Khan MZ, Khan S, Khan A, Khan MA, Khattak MB. Frequency of Iron Deficiency Anemia in Chronic Kidney Disease Patients on Hemodialysis. National Editorial Advisory Board. 2018 Nov; 29(11).

Kamil F, Dhrolia M, Hamid A, Qureshi R, Nasir K, Ahmad A. Frequency of iron deficiency anaemia in chronic kidney disease patients 3 not on dialysis 4. Journal of the Pakistan Medical Association. 2022 Jul; 72(7): 1396-400. doi: 10.47391/JPMA.4507. DOI: https://doi.org/10.47391/JPMA.4507

Khan M, Mahmood SN, Fatima N. Frequency of Iron Deficiency Anemia in Non-Dialysis Chronic Kidney Patients. Pakistan Journal of Kidney Diseases. 2022 Sep; 6(3): 17-22. doi: 10.53778/pjkd63191. DOI: https://doi.org/10.53778/pjkd63191

Adamu AL, Crampin A, Kayuni N, Amberbir A, Koole O, Phiri A et al. Prevalence and risk factors for anemia severity and type in Malawian men and women: urban and rural differences. Population Health Metrics. 2017 Dec; 15: 1-5. doi: 10.1186/s12963-017-0128-2. DOI: https://doi.org/10.1186/s12963-017-0128-2

Rostoker G, Andrivet P, Pham I, Griuncelli M, Adnot S. A modified Cockcroft-Gault formula taking into account the body surface area gives a more accurate estimation of the glomerular filtration rate. Journal of Nephrology. 2007 Sep; 20(5): 576-85.

Chen TK, Knicely DH, Grams ME. Chronic kidney disease diagnosis and management: a review. JAMA. 2019 Oct; 322(13): 1294-304. doi: 10.1001/jama.2019.14745. DOI: https://doi.org/10.1001/jama.2019.14745

Alemu B, Techane T, Dinegde NG, Tsige Y. Prevalence of anemia and its associated factors among chronic kidney disease patients attending selected public hospitals of Addis Ababa, Ethiopia: Institutional-based cross-sectional study. International Journal of Nephrology and Renovascular Disease. 2021 Mar: 67-75. doi: 10.2147/IJNRD.S296995. DOI: https://doi.org/10.2147/IJNRD.S296995

Alsalmani AA, Alalawi NM, Alsumri H, Aljabri MK, Alharami G, Alweshahi R et al. Prevalence of anemia in primary care patients with Type 2 diabetes mellitus and chronic kidney disease in Oman. Journal of Family and Community Medicine. 2023 Jan; 30(1): 18-22. doi: 10.4103/jfcm.jfcm_226_22. DOI: https://doi.org/10.4103/jfcm.jfcm_226_22

Pakianathan R, Kassab YW, Wen LS, Khan SU, Iqbal MZ. Prevalence of anemia and its management among chronic kidney disease patients in Malaysia. Latin American Journal of Pharmacy. 2021; 40(3): 599-608.

LEONG LC. POS-237 Prevalence and risk factors of anemia among non-dialysis chronic kidney disease patients: a single-centre, cross-sectional study from Malaysia. Kidney International Reports. 2022 Feb; 7(2): S104. doi: 10.1016/j.ekir.2022.01.256. DOI: https://doi.org/10.1016/j.ekir.2022.01.256

Salman M, Khan AH, Adnan AS, Sulaiman SA, Hussain K, Shehzadi N et al. Prevalence and management of anemia in pre-dialysis Malaysian patients: A hospital-based study. Revista da Associação Médica Brasileira. 2016; 62: 742-7. doi: 10.1590/1806-9282.62.08.742. DOI: https://doi.org/10.1590/1806-9282.62.08.742

Garrido D, Fontalvo N, Espinoza I, Arias L, Valarezo S, Almeida D et al. Description of iron deficiency in patients with end-stage chronic kidney disease on hemodialysis, Quito, Ecuador. Revista Colombiana de Nefrología. 2019 Dec; 6(2): 95-102. doi: 10.22265/acnef.6.2.342. DOI: https://doi.org/10.22265/acnef.6.2.342

Akizawa T, Okumura H, Alexandre AF, Fukushima A, Kiyabu G, Dorey J. Burden of anemia in chronic kidney disease patients in Japan: a literature review. Therapeutic Apheresis and Dialysis. 2018 Oct; 22(5): 444-56. doi: 10.1111/1744-9987.12712. DOI: https://doi.org/10.1111/1744-9987.12712

Ali I, Khan MNA, Ali A, Hussain MZ, Khan MS, Ahmed SN (2022) Anaemia in Chronic Kidney Disease. Pakistan Armed Forces Medical Journal 72:1306–09. DOI: https://doi.org/10.51253/pafmj.v72i4.4710

Khan AM, Afridi MA, Ali G, Idrees M, Waqas M. Prevalence of anemia in chronic kidney disease patients in lady reading hospital, Peshawar. Khyber Journal of Medical Sciences. 2018 Sep; 11(3): 439-42.

Rajput R, Ahmad N, Khan A, Wahid A, Atif M. Prevalence, Risk Factors and Management of Anaemia in Non-Dialysis Chronic Kidney Disease Patients: Findings from A Single Centre Study in Pakistan. Specialty Journal of Medical Research and Health Science. 2020; 5(1): 8-15.

Taderegew MM, Wondie A, Terefe TF, Tarekegn TT, GebreEyesus FA, Mengist ST et al. Anemia and its predictors among chronic kidney disease patients in Sub-Saharan African countries: A systematic review and meta-analysis. PLOS One. 2023 Feb; 18(2): e0280817. doi: 10.1371/journal.pone.0280817. DOI: https://doi.org/10.1371/journal.pone.0280817

Stauffer ME and Fan T. Prevalence of anemia in chronic kidney disease in the United States. PLOS One. 2014 Jan; 9(1): e84943. doi: 10.1371/journal.pone.0084943. DOI: https://doi.org/10.1371/journal.pone.0084943

Dmitrieva O, de Lusignan S, Macdougall IC, Gallagher H, Tomson C, Harris K et al. Association of anaemia in primary care patients with chronic kidney disease: cross sectional study of quality improvement in chronic kidney disease (QICKD) trial data. BMC Nephrology. 2013 Dec; 14: 1-9. doi: 10.1186/1471-2369-14-24. DOI: https://doi.org/10.1186/1471-2369-14-24

Lamerato L, James G, van Haalen H, Hedman K, Sloand JA, Tang A et al. Epidemiology and outcomes in patients with anemia of CKD not on dialysis from a large US healthcare system database: a retrospective observational study. BMC Nephrology. 2022 Apr; 23(1): 166. doi: 10.1186/s12882-022-02778-8. DOI: https://doi.org/10.1186/s12882-022-02778-8

Downloads

Published

2024-05-31
CITATION
DOI: 10.54393/pjhs.v5i05.1542
Published: 2024-05-31

How to Cite

Shuaib, M., Imran, M., Khan, H. A., Ikram ul Haq, M., Zubair, H. M., & Irfan, M. (2024). Iron Deficiency Anemia in Patients with Chronic Renal Insufficiency at Tertiary Care Hospital in Northern Punjab: Iron Deficiency Anemia in Chronic Renal Disease. Pakistan Journal of Health Sciences, 5(05), 65–69. https://doi.org/10.54393/pjhs.v5i05.1542

Issue

Section

Original Article

Plaudit

Most read articles by the same author(s)