EVALUATION OF ANEMIA IN PATIENTS REFERRED BY PRIMARY CARE PHYSICIANS TO NEPHROLOGY

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https://storage.unitedwebnetwork.com/files/1099/05ec489073c9d10448616cebf5c71a02.pdf

Abstract Title

First Name *

Karen

Last Name *

Courville SNI

Co-author 1

Maydelin Pecchio angel_mpm@yahoo.com Hospital Dr. Gustavo N. Collado Infectology Chitre

Co-author 2

Norman Bustamante normanemilio21@hotmail.com Hospital Dr. Gustavo N. Collado Nephrology Chitre

Co-author 3

Virginia Nuñez Samudio vnunez@institutodecienciasmedicas.org Instituto de Ciencias Médicas Epidemiología Las Tablas

Co-author 4

Iván Landires ilandires@institutodecienciasmedicas.org Instituto de Ciencias Médicas Research Las Tablas

Co-author 5

Gumercindo Pimentel Peralta gumercindopimentel@gmail.com Instituto de Ciencias Médicas Data Analysis Las Tablas

Co-author 6

Raul Cumbrera raulcumbrera@gmail.com Instituto de Ciencias Médicas Data Analysis Las Tablas

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Anemia is a complication in chronic kidney disease and is due to insufficient endogenous erythropoietin production and/or a decreased erythropoietic response, as a consequence of the inflammatory state secondary to uremic toxins; in addition to nutritional deficiencies and decreased half-life of erythrocytes, as added factors. As the glomerular filtration rate decreases between 30 ml/min/m2 and 15 ml/min/m2, the percentage of patients who present some degree of anemia increases. The identification of anemia in these stages prior to the start of dialysis and its management is important to reduce the state of tissue hypoxia that worsens physical capacity and reduces quality of life, by producing cardiovascular worsening in patients with hypertension, diabetes mellitus, dyslipidemia and obesity.

Methods

This is a retrospective, cross-sectional study that evaluated patients over 18 years of age who were referred to the Nephrology outpatient clinic of the Dr. Gustavo N. Collado Hospital in Panama, during the year 2017, with a glomerular filtration rate between 30 ml/min/ m2 at 15 ml/min/m2. Reference cause, hemoglobin value, and treatment indicated by the primary physician at the time of the first evaluation were evaluated. Anemia was defined as hemoglobin (Hb) less than 11 g/dL and severe anemia as Hb less than 10 g/dL. Patients with a diagnosis of upper or lower gastrointestinal bleeding, known hemoglobinopathies, or known hematological malignancies were excluded.

Results

Conclusions

Although the prevalence of anemia in this population is more than 50%, this study demonstrates that in our region, primary care physicians are not sensitized to the diagnosis or management of anemia in pre-dialysis stages. It is known that the main cause of death in these patients continues to be cardiovascular, so the management of anemia is important to reduce the risk of left ventricular hypertrophy, heart failure and blood transfusions, so it is important to improve the diagnosis and treatment with primary care physicians, before referral to the Nephrologist.

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