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Prevalence of Anemia in the Nursing Home: Contribution of Chronic Kidney Disease

Authors

  • Bruce Robinson MD, MPH,

    1. From the *Department of Geriatrics, Florida State University College of Medicine, Sarasota, FloridaDepartment of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IllinoisDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada§Amgen Inc., Thousand Oaks, California.
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  • Andrew S. Artz MD, MS,

    1. From the *Department of Geriatrics, Florida State University College of Medicine, Sarasota, FloridaDepartment of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IllinoisDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada§Amgen Inc., Thousand Oaks, California.
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  • Bruce Culleton MD, MSc,

    1. From the *Department of Geriatrics, Florida State University College of Medicine, Sarasota, FloridaDepartment of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IllinoisDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada§Amgen Inc., Thousand Oaks, California.
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  • Cathy Critchlow PhD,

    1. From the *Department of Geriatrics, Florida State University College of Medicine, Sarasota, FloridaDepartment of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IllinoisDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada§Amgen Inc., Thousand Oaks, California.
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  • Angela Sciarra PharmD,

    1. From the *Department of Geriatrics, Florida State University College of Medicine, Sarasota, FloridaDepartment of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IllinoisDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada§Amgen Inc., Thousand Oaks, California.
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  • Paul Audhya MD

    1. From the *Department of Geriatrics, Florida State University College of Medicine, Sarasota, FloridaDepartment of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IllinoisDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada§Amgen Inc., Thousand Oaks, California.
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  • Results from this study were presented at The American Society of Nephrology Annual Meeting, Philadelphia, Pennsylvania, November 8–13, 2005, and the American Society of Consultant Pharmacists Meeting, Boston, Massachusetts, November 9–13, 2005.

Address correspondence to Bruce Robinson, Sarasota Memorial Hospital Department of Geriatrics, 1700 South, Tamiami Trail, Sarasota, FL 34239. E-mail: Bruce-Robinson@smh.com

Abstract

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 m2, 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.

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