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Bernstein Mar 11 2009 Anemia Ii
1. Anemia in CKD Part 2 of 2 Division of Nephrology and Hypertension East Carolina University Brody School of Medicine
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9. The Prevalence of Anemia in CKD Curr Med Res Opin. 2004;20:1501-1510 .
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Notas do Editor
Creatinine clearance used to be the most commonly used estimation of GFR. You measure the amount of creatinine that is cleared from the plasma in a given time period. Cr clearance overestimates GFR because it is secreted into the tubular lumen in addition to being freely filtered. The formula to remember is UV/P Normal is 100-140cc/min and women may have a slightly lower clearance depending on muscle mass.
This figure from Wm McClellan’s PAERI study demonstrates that the prevalence of anemia is strongly associated with the severity of CKD among 5000 CKD patient none of whom were receiving erythropoeitin. PAERI Study: Prospective, multicenter, cross-sectional study Primary care offices CKD: Scr 2-6 mg/dL men; 1.5-6 mg/dL women 5222 patients evaluated -mean age 68.2 years; ~54% female; ~23% black Mean Ccr 39.1 (~35% had Ccr < = 30 mL/min; n=5171) ~39% had Hb >10 g/dL but <=12; ~9% had a Hb <=10 g/dL (n=5171) Women, diabetics, blacks and Hispanics were more likely to have a Hb <=12 g/dL At Ccr of <= 15, ~76% of patients had a Hb <= 12 g/dL and ~30% had a Hb <= 10 g/dL (n=172) A Ccr reduction of 10 mL/min was associated with a 23% increased odds of having a Hb <= 12 g/dL and a 35% increased odds of having a Hb <= 10 g/dL. AS COMPARED TO: 15,000 participants in the NHANES study Prevalence of anemia: 1% at an eGFR of 60cc/min per 1.73 m2 9% at an eGFR of 30cc/min per 1.73 m2 33-67% at an eGFR of 15cc/min per 1.73 m2
Creatinine clearance used to be the most commonly used estimation of GFR. You measure the amount of creatinine that is cleared from the plasma in a given time period. Cr clearance overestimates GFR because it is secreted into the tubular lumen in addition to being freely filtered. The formula to remember is UV/P Normal is 100-140cc/min and women may have a slightly lower clearance depending on muscle mass.
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