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Prevalence of Anemia in the Nursing Home: Contribution of Chronic Kidney Disease
Author(s) -
Robinson Bruce,
Artz Andrew S.,
Culleton Bruce,
Critchlow Cathy,
Sciarra Angela,
Audhya Paul
Publication year - 2007
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2007.01389.x
Subject(s) - medicine , kidney disease , anemia , odds ratio , renal function , confidence interval , hemoglobin , creatinine , retrospective cohort study , medical record
OBJECTIVES: To assess the independent contribution of chronic kidney disease (CKD) and age to anemia in older nursing home residents. DESIGN: Retrospective. SETTING: Skilled nursing facility. PARTICIPANTS: Nursing home residents with records in the Beverly Healthcare Data Warehouse who were admitted to a nursing home between January 1, 2002, and December 31, 2003; were alive as of January 31, 2004; and had hemoglobin and serum creatinine (SCr) values available for analysis. MEASUREMENTS: Prevalence of anemia (hemoglobin <13 g/dL for men and <12 g/dL for women) and CKD (estimated glomerular filtration rate <60 mL/min per 1.73 m 2 , according to Modification of Diet in Renal Disease criteria) and the contribution of CKD and age to the prevalence of anemia. RESULTS: Six thousand two hundred resident records were analyzed (70% female, 85% Caucasian). Overall, 59.6% of residents were anemic, and 43.1% had CKD, and residents with CKD were more likely to have anemia (64.9% with vs 55.7% without CKD; odds ratio (OR)=1.47, 95% confidence interval (CI)=1.33–1.63). Although older age was associated with lower hemoglobin values primarily in residents without CKD (Spearman rank correlation coefficient ( r )=−0.10, P <.001), age had no association with hemoglobin in CKD (Spearman r =0.01, P =.60). The greater risk of anemia in the presence of CKD persisted in each age category (OR=2.07, 95% CI=1.53–2.80, aged 65–74; OR=1.44, 95% CI=1.21–1.70, aged 75–84; and OR=1.35, 95% CI=1.15–1.57, aged ≥85). CONCLUSION: Overall, these results suggest that CKD contributes more strongly than older age to the high prevalence of anemia in older nursing home residents.