TY  - JOUR
T1  - Association of kidney function with anemia: The third national health and nutrition examination survey (1988-1994)
AU  - Astor BC, Muntner P, Levin A, Eustace JA, Coresh J
Y1  - 2002/06/24
N1  - 10.1001/archinte.162.12.1401
JO  - Archives of Internal Medicine
SP  - 1401
EP  - 1408
VL  - 162
IS  - 12
N2  - Background 
    Kidney failure is known to cause anemia, which is associated with a higher risk of cardiac failure and mortality. The impact of milder decreases in kidney function on hemoglobin levels and anemia in the US population, however, is unknown.Methods 
    We analyzed a population-based sample of 15419 participants 20 years and older in the Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994.Results 
    Lower kidney function was associated with a lower hemoglobin level and a higher prevalence and severity of anemia below, but not above, an estimated glomerular filtration rate (GFR) of 60 mL/min per 1.73 m2. Adjusted to the age of 60 years, the predicted median hemoglobin level among men (women) decreased from 14.9 (13.5) g/dL at an estimated GFR of 60 mL/min per 1.73 m2 to 13.8 (12.2) g/dL at an estimated GFR of 30 mL/min per 1.73 m2 and to 12.0 (10.3) g/dL at an estimated GFR of 15 mL/min per 1.73 m2. The prevalence of anemia (hemoglobin level <12 g/dL in men and <11 g/dL in women) increased from 1% (95% confidence interval, 0.7%-2%) at an estimated GFR of 60 mL/min per 1.73 m2 to 9% (95% confidence interval, 4%-19%) at an estimated GFR of 30 mL/min per 1.73 m2 and to 33% (95% confidence interval, 11%-67%) at an estimated GFR of 15 mL/min per 1.73 m2 among men and to 67% (95% confidence interval, 30%-90%) at an estimated GFR of 15 mL/min per 1.73 m2 among women. An estimated GFR of 15 to 60 mL/min per 1.73 m2 was present in 4% of the entire population and in 17% of the individuals with anemia.Conclusion 
    Below an estimated GFR of 60 mL/min per 1.73 m2, lower kidney function is strongly associated with a higher prevalence of anemia among the US adult population.
SN  - 0003-9926
M3  - doi: 10.1001/archinte.162.12.1401
UR  - http://dx.doi.org/10.1001/archinte.162.12.1401
ER  -