Prevalence and associated factors of anemia among adult non-dialysis chronic kidney disease patients attending Hawassa University College of Medicine and Health sciences Comprehensive Specialized Hospital and Shashamane Referral Hospital, Ethiopia, 2019

Abstract

Abstract Background: Anemia is common complication in chronic kidney disease (CKD) patients. It is mainly caused by erythropoietin deficiency due to kidney failure. Iron deficiency, inflammation and blood loss are also other factors that cause anemia. However, little is known about the prevalence of anemia and its associated factors among CKD patients in Ethiopia. Objective: The main aim of this study was to determine prevalence and associated factors of anemia among non-dialysis CKD patients from February to April 2019 Method: A cross sectional study was conducted on 384 newly diagnosed CKD patients at Hawassa and Shashamane referral hospitals. Systematic random sampling technique was used to select participants. Socio-demographic and clinical data were collected using questionnaire and medical records after getting informed consent. Adjusted hemoglobin was taken from complete blood count results to define anemia. Blood films and serum ferritin were done for anemic participants to determine morphology and iron status respectively. Frequency distribution table and graphs were used to describe descriptive statistics. Continuous variables were presented by median and interquartile range depends on Kolmogorov-Smirnov normality tests. Numbers and percentages were used for categorical variables. SPSS version 25.0 statistical software was used for data analysis. Binary and multivariable logistic regressions were used to determine predictors. P-value <0.05 was considered as statistically significant. Results: The overall prevalence of anemia was 44.0% (169/384; 95% CI: 39.0%, 48.9%); of which 7.1%, 62.1% and 30.8% of anemic CKD patients had mild, moderate and severe anemia, respectively. Morphologically, normocytic normochromic anemia was most predominant types of anemia. Prevalence of anemia increased from 20.6% in stage 2 to 100% in stage 5 CKD. In this study, 11.8% of anemic CKD patients had iron deficiency anemia. Cardiovascular disease [adjusted odds ratio (AOR) =2.37, 95%CI: 1.35, 4.16], diabetes mellitus (AOR=2.77, 95%CI: 1.08, 7.14), stage 3b CKD (AOR=2.74, 95%CI: 1.31, 5.73) and stage 4-5 CKD (AOR=7.11, 95%CI: 3.22, 15.72) showed significant association with anemia. Conclusion: This finding showed anemia was more prevalent in CKD patients, and associated with cardiovascular disease, diabetes mellitus and stages of CKD. So, early diagnosis and treatment and prevention of anemia are needed to be focused for CKD patients.