RESEARCH - Anemia and renal function in patients with RA

August 26, 2008

J Rheumatol. 2006 Aug;33(8):1516-22.

Anemia and renal function in patients with rheumatoid arthritis.

Wolfe F, Michaud K.

National Data Bank for Rheumatic Diseases, University of Kansas School of

Medicine, Wichita, 67214, USA. fwolfe@...

OBJECTIVE: Treatments are now available that can improve the anemia of

chronic illnesses such as rheumatoid arthritis (RA). Despite recognition

that anemia is common in RA and that renal function may be impaired and

affect hemoglobin levels, there are almost no quantitative comparative data

regarding the prevalence of anemia or decreased renal function in RA.

METHODS: We studied a prospectively acquired clinical database of 2,120

patients with RA who had 26,221 hemoglobin determinations, and a control

population of 7,124 patients with noninflammatory rheumatic disorders (NIRD)

who had 12,086 determinations. RESULTS: Using the World Health Organization

definition, anemia occurred in 31.5% of patients with RA, and followed a

U-shaped distribution that had minimal prevalence around 60 years of age.

Anemia prevalence in men was 30.4% and in women 32.0%. Anemia occurred in

11.1% at hemoglobin < 11 g/dl and 3.4% at hemoglobin < 10 g/dl. After

erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) was the

strongest predictor of anemia, followed by estimated creatinine clearance.

Adjusted for age and sex, estimated creatinine clearance was 9.8 (95% CI 7.5

to 12.1) ml/min lower in patients with RA than in those with NIRD.

CONCLUSION: Anemia occurs in 31.5% of RA patients, 3 times the rate in the

general population. However, severe chronic anemia (hemoglobin < 10 g/dl) is

rare (3.4%). In addition, renal function is impaired in patients with RA

compared with NIRD. Renal function has a small effect on the anemia of RA,

and ESR and CRP have slightly greater effects.

PMID: 16881108

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Not an MD

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