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Indicator Details — Children and Adolescents: Prevalence of Anemia Among Children with CKDa
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a Anemia defined as hemoglobin level <5th percentile for age and sex. Adapted from Atkinson et al. (2010).

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 MeasurePrevalence of anemia among children with CKD
Data SourceCKiD prospective observational cohort study
Type of Data SourcePrivate
Data SetCKiD summarized data
Health Care System DataNo
Regional or National?National
Demographic GroupChildren (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
NumeratorEnrolled children/adolescents of white or African-American race with hemoglobin data and hemoglobin level <5th percentile for age and sex of normal children/adolescents
DenominatorEnrolled children/adolescents of white or African-American race with hemoglobin data
Definition of CKDSchwartz-estimated GFR of 30-90 ml/min/1.73 m² (for entry into study)
Glomerular filtration rateMeasured, by iohexol
Primary Data Source IndicatorAnemia
Primary Indicator Method of MeasurementHemoglobin from baseline study visit, performed locally
Secondary (1) VariableRace
Secondary (1) Indicator Method of MeasurementSelf-report
Secondary (2) VariableMedication use
Secondary (2) Indicator Method of MeasurementSelf-report
Frequency of Measurement (Primary)Once (baseline)
U.S. Region Covered by Primary VariableAll
Period Currently Available2004–2008
Pending DataNone for baseline; further visits scheduled
Additional Data Items of InterestBMI, sex, ethnicity, SES
Limitations of IndicatorOther and multiple races not examined; hemoglobin and treatment may change over the course of disease
Analytical ConsiderationsData summarized by CKiD investigators (see Atkinson et al.); as with all cohort studies, selection bias and possible confounding
References and Sources:

Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd