Published: 2022-08-24

Prevalence of anemia among chronic kidney disease patients in India: a single-centre study

Abdullah Zaawari, K. L. Tejaswini, G. D. Davina, Anushalini Singanaveni


Background: Chronic kidney disease is defined as abnormalities in kidney structure or function with a decreased glomerular filtration rate <60 ml/min for three months or more, irrespective of the cause. CKD has many complications that usually develop throughout disease progression. Anemia is among these complications. The prevalence of anemia is very high among CKD patients and it is an important parameter to be monitored and addressed. This research study aimed to find out the prevalence of anemia among CKD patients and investigate the relationship between anemia and other predictive factors.

Methods: This was a unicenter, cross-sectional, prospective observational study conducted for six months between December 2020 and May 2021 at a tertiary care hospital to assess the prevalence of anemia among CKD patients. Data were collected, coded, and analyzed using SPSS software. A descriptive analysis was performed, and significance tests were applied where applicable. Multiple regression analysis and Pearson tests were applied to determine the relationship between variables, p>0.05 was considered statistically significant.

Results: A total of 715 patients were enrolled in the study, out of which 432 (59.2%) and 292 (40.8%) were male and female, respectively. The mean age was 56.4±15 SD. Out of 715 patients, 531 (74.3%) patients were anemic and 58 (8.1%) were severely anemic. Thus, the prevalence of anemia was 82.4% among study participants. Hypertension, diabetes, and CKD stage were associated with a high prevalence of anemia.

Conclusions: This study reported a high prevalence of anemia compared to previous studies. Assessing the anemic status of patients in earlier stages of the disease will contribute greatly to managing this complication.


Chronic kidney disease, Anemia, Prevalence, Hypertension, Diabetes

Full Text:



Levey AS, Eckardt KU, Tsukamoto Y. Definition and classification of chronic kidney disease: a position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int. 2005;67(6): 2089-100.

Inker LA, Astor BC, Fox CH. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014;63(5):713-35.

Zaawari A. Rapidly progressive IgA nephropathy leads to end-stage renal disease: a case report. Int J Inno Sci Res Tech. 2021;6(1):916-8.

Levin A, Stevens PE, Bilous RW, Coresh J. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013:3:1-150.

Bello AK, Alrukhaimi M, Ashuntantang GE. Complications of chronic kidney disease: current state, knowledge gaps, and strategy for action. Kidney Int Suppl. 2017;7(2):122-9.

Eckardt KU. Erythropoietin: oxygen-dependent control of erythropoiesis and its failure in renal disease. Nephron. 1994;67:7-23.

Hsu CY, Bates DW, Kuperman GJ, Curhan GC. Relationship between hematocrit and renal function in men and women. Kidney Int. 2001;59(2):725-31.

Stauffer ME, Fan T. Prevalence of anemia in chronic kidney disease in the United States. PLoS One. 2014; 9(1):e84943.

Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. Lancet. 2017;389(10075): 1238-52.

Hayashi T, Maruyama S, Nangaku M. Darbepoetin Alfa in Patients with Advanced CKD without Diabetes: Randomized, Controlled Trial. Clin J Am Soc Nephrol. 2020;15(5):608-15.

Liu M, Li XC, Lu L. Cardiovascular disease and its relationship with chronic kidney disease. Eur Rev Med Pharmacol Sci. 2014;18(19):2918-26.

Karohl C, Raggi P. Approach to cardiovascular disease prevention in patients with chronic kidney disease. Curr Treat Options Cardiovasc Med. 2012; 14(4):391-413.

Adera H, Hailu W, Adane A, Tadesse A. Prevalence of anemia and its associated factors among chronic kidney disease patients at university of gondar hospital, northwest Ethiopia: a hospital-based cross sectional study. Int J Nephrol Renovasc Dis. 2019; 12:219-28.

Ammirati AL. Chronic kidney disease. Rev Assoc Med Bras. 2020;66(1):s03-9.

Alharbi R. Prevalence, and severity of anemia in CKD patients. Egypt Acad J Biol Sci Physiol Mol Biol. 2019;11(2):71-83.

McClellan W, Aronoff SL, Bolton WK. The prevalence of anemia in patients with chronic kidney disease. Curr Med Res Opin. 2004;20(9):1501-10.

Sofue T, Nakagawa N, Kanda E. 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). PLoS One. 2020;15(7): e0236132.

Hussain S, Habib A, Najmi AK. Anemia prevalence and its impact on health-related quality of life in Indian diabetic kidney disease patients: Evidence from a cross-sectional study. J Evid Based Med. 2019;12(4):243-52.

Shen Y, Wang J, Yuan J. Anemia among Chinese patients with chronic kidney disease and its association with quality of life - results from the Chinese cohort study of chronic kidney disease (C-STRIDE). BMC Nephrol. 2021;22(1):64.

Parfrey PS, Foley RN, Wittreich BH, Sullivan DJ, Zagari MJ, Frei D. Double-blind comparison of full and partial anemia correction in incident hemodialysis patients without symptomatic heart disease. J Am Soc Nephrol. 2005;16(7):2180-9.