Anaemia due to chronic kidney disease: A cross-sectional analysis from a tertiary referral centre in Sri Lanka

Introduction: Anaemia is a common complication of chronic kidney disease (CKD) that adversely affects cardiovascular health and quality of life. Data on anaemia in Sri Lankan CKD patients is scarce.
Objectives: This study was conducted to assess the prevalence, associations, and treatment response of anaemia in a cohort of patients with CKD.
Methodology: A descriptive cross-sectional study was conducted among consecutive, consenting adult patients with stable CKD attending clinics and wards of the University Medical Unit, Colombo North Teaching Hospital, Ragama.
Results: Of 149 patients with CKD (males 57.7%), 70.5% had diabetes, 83.9% had hypertension and 37.6% had ischemic heart disease. Anaemia was present in 90.6% of females and 93% of males. The severity of anaemia was significantly (p=<.05) associated with female gender, advancing CKD stage, diabetes, chronic liver cell disease, being on dialysis, and increasing degree of proteinuria.
Of 91 patients investigated for the cause of anaemia, 60.4% had iron deficiency with anaemia of chronic disease, while 27.5% had anaemia of chronic disease based on the blood picture. Of 88 patients with haemoglobin <10g/dl, only 45.4% were on erythropoietin and 56.8% had received blood transfusions. 76.1%  of the anaemic patients had hemoglobin below 10g/dL at follow-up despite treatment.
Conclusions: Anaemia was highly prevalent in the CKD cohort with a significant number requiring transfusions. Patients continued to have anaemia despite being treated with nutritional supplements and erythropoietin.