. 2020 Jul 20;15(7):e0236132.

doi: 10.1371/journal.pone.0236132. eCollection 2020.

Prevalence of anemia in patients with chronic kidney disease in Japan: A nationwide, cross-sectional cohort study using data from the Japan Chronic Kidney Disease Database (J-CKD-DB)

Tadashi Sofue¹, Naoki Nakagawa², Eiichiro Kanda³, Hajime Nagasu⁴, Kunihiro Matsushita⁵, Masaomi Nangaku⁶, Shoichi Maruyama⁷, Takashi Wada⁸, Yoshio Terada⁹, Kunihiro Yamagata¹⁰, Ichiei Narita¹¹, Motoko Yanagita¹², Hitoshi Sugiyama¹³, Takashi Shigematsu¹⁴, Takafumi Ito¹⁵, Kouichi Tamura¹⁶, Yoshitaka Isaka¹⁷, Hirokazu Okada¹⁸, Kazuhiko Tsuruya^{19

20}, Hitoshi Yokoyama²¹, Naoki Nakashima²², Hiromi Kataoka²³, Kazuhiko Ohe²⁴, Mihoko Okada²⁵, Naoki Kashihara⁴

Affiliations

¹ Division of Nephrology and Dialysis, Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan.
² Division of Cardiology, Nephrology, Respiratory and Neurology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.
³ Medical Science, Kawasaki Medical School, Kurashiki, Japan.
⁴ Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
⁵ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
⁶ Division of Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
⁷ Division of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
⁸ Division of Nephrology, Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan.
⁹ Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kochi, Japan.
¹⁰ Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
¹¹ Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
¹² Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
¹³ Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
¹⁴ Division of Nephrology, Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
¹⁵ Division of Nephrology, Faculty of Medicine, Shimane University, Izumo, Japan.
¹⁶ Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
¹⁷ Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.
¹⁸ Department of Nephrology, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
¹⁹ Department of Integrated Therapy for Chronic Kidney Disease, Kyushu University, Fukuoka, Japan.
²⁰ Department of Nephrology, Nara Medical University, Kashihara, Japan.
²¹ Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan.
²² Department of Advanced Information Technology, Kyushu University, Fukuoka, Japan.
²³ Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Japan.
²⁴ Department of Healthcare Information Management, The University of Tokyo Hospital, Tokyo, Japan.
²⁵ Institute of Health Data Infrastructure for All, Tokyo, Japan.

PMID: 32687544
PMCID: PMC7371174
DOI: 10.1371/journal.pone.0236132

Prevalence of anemia in patients with chronic kidney disease in Japan: A nationwide, cross-sectional cohort study using data from the Japan Chronic Kidney Disease Database (J-CKD-DB)

Tadashi Sofue et al. PLoS One. 2020.

. 2020 Jul 20;15(7):e0236132.

doi: 10.1371/journal.pone.0236132. eCollection 2020.

Authors

Affiliations

¹ Division of Nephrology and Dialysis, Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan.
² Division of Cardiology, Nephrology, Respiratory and Neurology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.
³ Medical Science, Kawasaki Medical School, Kurashiki, Japan.
⁴ Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
⁵ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
⁶ Division of Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
⁷ Division of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
⁸ Division of Nephrology, Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan.
⁹ Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kochi, Japan.
¹⁰ Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
¹¹ Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
¹² Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
¹³ Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
¹⁴ Division of Nephrology, Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
¹⁵ Division of Nephrology, Faculty of Medicine, Shimane University, Izumo, Japan.
¹⁶ Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
¹⁷ Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.
¹⁸ Department of Nephrology, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
¹⁹ Department of Integrated Therapy for Chronic Kidney Disease, Kyushu University, Fukuoka, Japan.
²⁰ Department of Nephrology, Nara Medical University, Kashihara, Japan.
²¹ Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan.
²² Department of Advanced Information Technology, Kyushu University, Fukuoka, Japan.
²³ Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Japan.
²⁴ Department of Healthcare Information Management, The University of Tokyo Hospital, Tokyo, Japan.
²⁵ Institute of Health Data Infrastructure for All, Tokyo, Japan.

PMID: 32687544
PMCID: PMC7371174
DOI: 10.1371/journal.pone.0236132

Abstract

Background: The Japan Chronic Kidney Disease Database (J-CKD-DB) is a nationwide clinical database of patients with chronic kidney disease (CKD) based on electronic health records. The objective of this study was to assess the prevalence of anemia and the utilization rate of erythropoiesis-stimulating agents (ESAs) in Japanese patients with CKD.

Methods: In total, 31,082 adult outpatients with estimated glomerular filtration rates of 5-60 ml/min/1.73 m2 in seven university hospitals were included this analysis. The proportions of patients with CKD stages G3b, G4, and G5 were 23.5%, 7.6%, and 3.1%, respectively.

Results: The mean (standard deviation) hemoglobin level of male patients was 13.6 (1.9) g/dl, which was significantly higher than the mean hemoglobin level of female patients (12.4 (1.6) g/dl). The mean (standard deviation) hemoglobin levels were 11.4 (2.1) g/dl in patients with CKD stage G4 and 11.2 (1.8) g/dl in patients with CKD stage G5. The prevalences of anemia were 40.1% in patients with CKD stage G4 and 60.3% in patients with CKD stage G5. Logistic regression analysis showed that diagnoses of CKD stage G3b (adjusted odds ratio [95% confidence interval]: 2.32 [2.09-2.58]), G4 (5.50 [4.80-6.31]), and G5 (9.75 [8.13-11.7]) were associated with increased prevalence of anemia. The utilization rates of ESAs were 7.9% in patients with CKD stage G4 and 22.4% in patients with CKD stage G5.

Conclusions: We determined the prevalence of anemia and utilization rate of ESAs in Japanese patients with CKD using data from a nationwide cohort study.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

**Fig 1. Mean hemoglobin level according to eGFR5 category.**
(a) All participants; (b) Men and women shown separately. Hb, hemoglobin; *, p<0.05.

**Fig 2. Hemoglobin distribution according to G category.**
(a) All participants; (b) Men; and (c) Women. Hb, hemoglobin.

See this image and copyright information in PMC

References

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Prevalence of anemia in patients with chronic kidney disease in Japan: A nationwide, cross-sectional cohort study using data from the Japan Chronic Kidney Disease Database (J-CKD-DB)

Affiliations

Prevalence of anemia in patients with chronic kidney disease in Japan: A nationwide, cross-sectional cohort study using data from the Japan Chronic Kidney Disease Database (J-CKD-DB)

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous