RESEARCH - Anemia and renal function in patients with RA

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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.

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

http://www.ncbi.nlm.nih.gov/pubmed/16881108

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