Prevalence and Associations of Anemia of CKD: Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES) 1999-2004
Section snippets
Definitions
KEEP and the NHANES database are fully described elsewhere in this supplement.15 Disease definitions are as follows. History of diabetes is defined as self-reported diabetes or retinopathy, and history of hypertension, as self-reported hypertension. Anemia is defined as hemoglobin level less than 13.5 g/dL (<135 g/L) for men and less than 12.0 g/dL (<120 g/L) for women (KDOQI 2006)10 or less than 13.0 g/dL (<130 g/L) for men and less than 12.0 g/dL (<120 g/L) for women (WHO). Obesity is defined
Results
The population screened for the KEEP program included 70,069 eligible participants. Anemia data were collected for all participants and data for key variables were collected for 51,727 (73.8%). The NHANES 1999-2004 cohort included 17,061 adult participants aged 18 years and older. Compared with NHANES, women and African Americans were overrepresented in KEEP. Of KEEP participants, 68.3% were women compared with 52% of NHANES participants (Table 1). Racial distribution in the KEEP population was
Discussion
Our study highlights several major differences between a targeted community-based screening program (KEEP) and a generalizable population health survey (NHANES 1999-2004). Greater percentages of KEEP participants were at risk of CKD and anemia, including African Americans, who were 3 times more prevalent in KEEP than NHANES. Risk factors for CKD and CVD5, 9, 14 also were better represented in KEEP populations than in NHANES. For example, obesity was 1.4 times; hypertension was 2 times; and
Acknowledgements
In addition to the authors listed, the Kidney Early Evaluation Program (KEEP) Investigators are Dennis Andress, MD, David Calhoun, MD, Bruce Johnson, MD, Claudine T. Jurkovitz, MD, MPH, Chamberlain I. Obialo, MD, Lesley A. Stevens, MD, and Michael G. Shlipak, MD.
The authors thank Shane Nygaard, BA, and Nan Booth, MSW, MPH of the Chronic Disease Research Group for manuscript preparation and manuscript editing, respectively.
Support: KEEP is a program of the National Kidney Foundation Inc and is
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A list of the members of the Kidney Early Evaluation Program Investigators appears at the end of this article.