Overall, 32% of children and adolescents with CKD had anemia, as defined by hemoglobin values <5th percentile for age and gender.
African-American children and adolescents were more likely to have anemia than their white counterparts (44% vs. 29%), despite similar levels of treatment.
Chart Explanation: Overall, 32% of pediatric CKD patients had anemia. African-American children and adolescents had a significantly higher prevalence of anemia than their white counterparts (44% vs. 29%, P=0.01). Mean hemoglobin rates were 12.3 and 12.6 g/dl, respectively, for African-American and white children and adolescents (P=0.09). However, rates of treatment with iron (27% and 30%) and erythropoietin-stimulating agents (14% and 15%) were not different for African-American and white participants.
The Chronic Kidney Disease in Children (CKiD) study is a prospective observational study of an estimated 500 children (1-16 years old) at 48 North American centers with varying degrees of CKD severity, which was designed to measure consequences in pediatric CKD patients. As with all cohort studies, recruitment bias and lack of representativeness may influence estimates.
Analyses for this measure were conducted in the 429 children enrolled in CKiD with completed baseline visits as of 1/09 with measured hemoglobin and medication information and who reported either white or African-American race. Complete methods can be found in Atkinson et al. (2010).
|Description of Measure||Prevalence of anemia among children with CKD|
|Data Source||CKiD prospective observational cohort study|
|Type of Data Source||Private|
|Data Set||CKiD summarized data|
|Health Care System Data||No|
|Regional or National?||National|
|Demographic Group||Children (1-16 years old) with mild to moderate CKD (Schwartz-estimated GFR of 30-90 ml/min/1.73 m²) who are treated throughout 44 pediatric nephrology centers in North America|
|Numerator||Enrolled children/adolescents of white or African-American race with hemoglobin data and hemoglobin level <5th percentile for age and sex of normal children/adolescents|
|Denominator||Enrolled children/adolescents of white or African-American race with hemoglobin data|
|Definition of CKD||Schwartz-estimated GFR of 30-90 ml/min/1.73 m² (for entry into study)|
|Glomerular filtration rate||Measured, by iohexol|
|Primary Data Source Indicator||Anemia|
|Primary Indicator Method of Measurement||Hemoglobin from baseline study visit, performed locally|
|Secondary (1) Variable||Race|
|Secondary (1) Indicator Method of Measurement||Self-report|
|Secondary (2) Variable||Medication use|
|Secondary (2) Indicator Method of Measurement||Self-report|
|Frequency of Measurement (Primary)||Once (baseline)|
|U.S. Region Covered by Primary Variable||All|
|Period Currently Available||2004–2008|
|Pending Data||None for baseline; further visits scheduled|
|Additional Data Items of Interest||BMI, sex, ethnicity, SES|
|Limitations of Indicator||Other and multiple races not examined; hemoglobin and treatment may change over the course of disease|
|Analytical Considerations||Data summarized by CKiD investigators (see Atkinson et al.); as with all cohort studies, selection bias and possible confounding|