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Clinical Trial
. 2004 Mar;52(3):423-7.
doi: 10.1111/j.1532-5415.2004.52116.x.

Mechanisms of unexplained anemia in the nursing home

Andrew S Artz  1 , Dean Fergusson, Paul J Drinka, Melvin Gerald, Rex Bidenbender, Anthony Lechich, Felix Silverstone, Mark A McCamish, Jinlu Dai, Evan Keller, William B Ershler
Affiliations
Free article
Clinical Trial

Mechanisms of unexplained anemia in the nursing home

Andrew S Artz et al. J Am Geriatr Soc. 2004 Mar.
Free article

Abstract

Objectives: To characterize anemia in elderly nursing home residents.

Design: Prospective multiinstitutional cohort study.

Setting: Five nursing homes.

Participants: From retrospective analysis, residents found to be anemic using chart review were prospectively randomized. Of the 81 residents enrolled, 60 were anemic.

Measurements: Chart review for medical history and factors related to treatment or history of anemia, extensive laboratory evaluation for causes of anemia, and classification of anemia by two hematologists.

Results: Among the 60 anemic residents, the causes of anemia were idiopathic (n=27), iron-deficiency (n=14), anemia associated with chronic disease (n=8), anemia of renal insufficiency (n=6), and other (n=5). The eryrthropoietin (EPO) response to anemia was lower in residents with idiopathic anemia (IA) than in those with iron-deficiency anemia, and this correlated with renal function as estimated using calculated creatinine clearance. In this elderly population, advancing age was not correlated with lower EPO response.

Conclusion: IA is common in nursing home residents. A lower EPO response contributes to the high prevalence of anemia in this setting and may be due, in part, to occult renal dysfunction.

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