OBJECTIVE: To determine the prevalence of anemia in a cohort of patients with diabetes and normal serum creatinine concentration in a primary care clinic. METHODS: We undertook a retrospective cohort study, comparing adult patients who had diabetes, with or without anemia. Patients older than 18 years who had diabetes were identified by using the computerized database for the years 2006 and 2007 in a primary care clinic. Patients with hemoglobin levels <13.7 g/dL (men <60 years old), < or =13.2 g/dL (men > or =60 years old), or <12.2 g/dL (women) with no known cause of anemia were identified and compared with patients who had diabetes but not anemia. All patients had normal serum creatinine levels (men < or =1.5 mg/dL and women < or =1.4 mg/dL). RESULTS: Of 594 eligible patients with diabetes, 192 (32%) had anemia. Older age, higher serum urea and creatinine levels, lower estimated glomerular filtration rates, and reduced serum iron levels were more common in the patients with diabetes who had anemia than in those without anemia. The prevalence of anemia was higher in patients treated with "glitazones," insulin, and angiotensin receptor blockers in comparison with those receiving other orally administered hypoglycemic medications. In stepwise logistic regression analysis, only serum creatinine, age, and use of glitazones retained statistical significance. CONCLUSION: In a community clinic, the prevalence of anemia in unselected patients with diabetes and normal serum creatinine levels was 32%. Factors associated with anemia were older age, higher serum creatinine levels, and use of glitazone therapy.
OBJECTIVE: To determine the prevalence of anemia in a cohort of patients with diabetes and normal serum creatinine concentration in a primary care clinic. METHODS: We undertook a retrospective cohort study, comparing adult patients who had diabetes, with or without anemia. Patients older than 18 years who had diabetes were identified by using the computerized database for the years 2006 and 2007 in a primary care clinic. Patients with hemoglobin levels <13.7 g/dL (men <60 years old), < or =13.2 g/dL (men > or =60 years old), or <12.2 g/dL (women) with no known cause of anemia were identified and compared with patients who had diabetes but not anemia. All patients had normal serum creatinine levels (men < or =1.5 mg/dL and women < or =1.4 mg/dL). RESULTS: Of 594 eligible patients with diabetes, 192 (32%) had anemia. Older age, higher serum urea and creatinine levels, lower estimated glomerular filtration rates, and reduced serum iron levels were more common in the patients with diabetes who had anemia than in those without anemia. The prevalence of anemia was higher in patients treated with "glitazones," insulin, and angiotensin receptor blockers in comparison with those receiving other orally administered hypoglycemic medications. In stepwise logistic regression analysis, only serum creatinine, age, and use of glitazones retained statistical significance. CONCLUSION: In a community clinic, the prevalence of anemia in unselected patients with diabetes and normal serum creatinine levels was 32%. Factors associated with anemia were older age, higher serum creatinine levels, and use of glitazone therapy.
Authors: Michelle M Estrella; Brad C Astor; Anna Köttgen; Elizabeth Selvin; Josef Coresh; Rulan S Parekh Journal: Nephrol Dial Transplant Date: 2010-02-22 Impact factor: 5.992