A cohort study of the relationship between anaemia, mean corpuscular volume and mortality among a CKD population in South Africa

• Published in: African health sciences Vol. 21; no. 4; pp. 1764 - 75
• Main Authors: Nalado, Aishatu, Waziri, Bala, Olorunfemi, Gbenga, Mahlangu, Johnny, Paget, Graham, Duarte, Raquel, Naicker, Saraladevi
• Format: Journal Article
• Language: English
• Published: Uganda Makerere Medical School 01.12.2021
• Subjects: Adult; Aged; Anemia - complications; Anemia - epidemiology; Cohort Studies; Erythrocyte Indices; Female; Humans; Male; Middle Aged; Renal Insufficiency, Chronic - epidemiology; South Africa - epidemiology; South Africa; Chronic kidney disease; mortality anaemia; outcomes; survival
• ISSN: 1680-6905; 1729-0503; 1680-6905
• DOI: 10.4314/ahs.v21i4.33

The burden of chronic kidney disease is increasing globally and prompt identification, coupled with improved management of CKD patients have increased the population of pre-dialysis patients. We, therefore, aimed to evaluate the predictors of survival among pre-dialysis CKD patients in South Africa. We conducted a cohort study of 256 consecutive consenting Black non-dialysis requiring CKD patients attending the renal outpatient clinic of a tertiary Hospital in South Africa from 1st June 2016 to 1st December 2016. Socio-demographic and clinical information of the participants were obtained. Descriptive statistics, Kaplan-Meier curves and Cox proportional hazard regression analyses were conducted to evaluate factors affecting the survival of the participants. The mean age of the participants was 52.8±14.3 years and 48.0% were females, 52% were males. The death rate increased with worsening haemoglobin level from 0.96 among patients with mild anaemia to 4.29 per 100-person years among patients with severe anaemia. Anaemic patients with GFR < 30mls/min had significantly increased risk of death (HR 11.51, 95% CI 1.62-78.32, P < 0.001). Mortality in pre-dialysis CKD patients was associated with anaemia and hyperphosphatemia. Clinical interventions targeted at preventing these conditions may improve outcomes among this group of CKD patients.