Management of anemia and iron parameters in chronic kidney patients

Anemia is a common complication in patients with chronic kidney disease (CKD). It is a risk factor for morbidity, mortality, and impaired quality of life. Therefore, early diagnosis of anemia in chronic kidney disease, evaluation of its etiology, and treatment are important. In this thesis, the demographic information, etiologies of CKD, severity of anemia, stages of CKD, investigations for anemia etiology, anemia treatment, improvement in anemia status, and survival status of 1321 patients with stage 3A and advanced CKD and anemia who admitted to the Hacettepe University Faculty of Medicine Nephrology Department from 2014 to 2018 were evaluated. The rate of testing for ferritin, which is required for the etiological evaluation of anemic patients, was 76.4%, while rates for B12, folic acid, and transferrin saturation testing were below 20%. It was found that 59.4% of patients with anemia did not receive any anemia treatment. As the follow-up periods of patients increased, it was shown that anemia treatment was better administered, leading to better achievement of target values. Among CKD patients with anemia, 34.8% had passed away. The overall survival rate was 79.8% in those whose anemia improved, while it was 62.8% in those whose anemia did not improve, and it was observed that patients whose anemia improved had longer survival (p=0.002). In conclusion, we recommend evaluating CKD patients with anemia under more optimal conditions and starting treatment as early as clinically indicated in order to improve their outcomes.