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Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia

BACKGROUND: Anemia is a common finding in patients with diabetes, even in the absence of kidney disease and is a risk factor for adverse outcomes, including all-cause and cardiovascular mortality. Despite this, relatively little is known about the burden of anemia among adults with diabetes in sub-S...

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Autores principales: Fiseha, Temesgen, Adamu, Aderaw, Tesfaye, Melkam, Gebreweld, Angesom
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6733511/
https://www.ncbi.nlm.nih.gov/pubmed/31498832
http://dx.doi.org/10.1371/journal.pone.0222111
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author Fiseha, Temesgen
Adamu, Aderaw
Tesfaye, Melkam
Gebreweld, Angesom
author_facet Fiseha, Temesgen
Adamu, Aderaw
Tesfaye, Melkam
Gebreweld, Angesom
author_sort Fiseha, Temesgen
collection PubMed
description BACKGROUND: Anemia is a common finding in patients with diabetes, even in the absence of kidney disease and is a risk factor for adverse outcomes, including all-cause and cardiovascular mortality. Despite this, relatively little is known about the burden of anemia among adults with diabetes in sub-Saharan Africa. The aim of this study was to determine the prevalence of anemia and its association with renal disease among diabetic adult outpatients attending a hospital in Northeast Ethiopia. METHODS: A cross-sectional study was conducted among 412 diabetic adults at the diabetes clinic of Dessie Referral hospital in Northeast Ethiopia, from January to April 2018. Each patient provided a blood sample for hemoglobin and serum creatinine levels and urine for albuminuria. Anemia was defined by World Health Organization criteria (<13 g/dl for men and <12 g/dl for women). Glomerular filtration rate (GFR) was estimated using the 4-variable Modification of Diet in Renal Disease (MDRD) equation. Chronic kidney disease (CKD) was classified into 5 stages based on the eGFR and albuminuria. RESULTS: Anemia was present in 26.7% of the participants, and CKD in 43.0%. Anemia was more prevalent in patients with CKD (39.5%) than those without CKD (17.0%; P < 0.001). The prevalence of anemia increased with stage of CKD, from 22.6% at stage 1 to 100% at stage 4. Fifteen percent of the patients had anemia below the treatment threshold of 11 g ⁄dl. In multivariate analysis, older age (AOR = 2.41, 95% CI 1.11–5.21); type 2 diabetes (AOR = 2.40, 95% CI 1.14–5.08); presence of hypertension (AOR = 3.78, 95% CI 1.35–10.57); high systolic BP (AOR = 1.05, 95% CI 1.02–1.08); serum creatinine (AOR = 12.80, 95% CI 3.90–87.98) and low GFR (AOR = 9.50, 95% CI 4.05–22.28) were independently associated with greater odds for the presence of anemia CONCLUSIONS: Anemia is commonly present among diabetic adults attending our diabetes outpatient clinic in Northeast Ethiopia, including those without kidney disease. Our findings highlight the need for incorporating anemia screening into routine diabetes care to enable early detection and treatment of anemia and hence improve the overall care of patients with diabetes.
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spelling pubmed-67335112019-09-20 Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia Fiseha, Temesgen Adamu, Aderaw Tesfaye, Melkam Gebreweld, Angesom PLoS One Research Article BACKGROUND: Anemia is a common finding in patients with diabetes, even in the absence of kidney disease and is a risk factor for adverse outcomes, including all-cause and cardiovascular mortality. Despite this, relatively little is known about the burden of anemia among adults with diabetes in sub-Saharan Africa. The aim of this study was to determine the prevalence of anemia and its association with renal disease among diabetic adult outpatients attending a hospital in Northeast Ethiopia. METHODS: A cross-sectional study was conducted among 412 diabetic adults at the diabetes clinic of Dessie Referral hospital in Northeast Ethiopia, from January to April 2018. Each patient provided a blood sample for hemoglobin and serum creatinine levels and urine for albuminuria. Anemia was defined by World Health Organization criteria (<13 g/dl for men and <12 g/dl for women). Glomerular filtration rate (GFR) was estimated using the 4-variable Modification of Diet in Renal Disease (MDRD) equation. Chronic kidney disease (CKD) was classified into 5 stages based on the eGFR and albuminuria. RESULTS: Anemia was present in 26.7% of the participants, and CKD in 43.0%. Anemia was more prevalent in patients with CKD (39.5%) than those without CKD (17.0%; P < 0.001). The prevalence of anemia increased with stage of CKD, from 22.6% at stage 1 to 100% at stage 4. Fifteen percent of the patients had anemia below the treatment threshold of 11 g ⁄dl. In multivariate analysis, older age (AOR = 2.41, 95% CI 1.11–5.21); type 2 diabetes (AOR = 2.40, 95% CI 1.14–5.08); presence of hypertension (AOR = 3.78, 95% CI 1.35–10.57); high systolic BP (AOR = 1.05, 95% CI 1.02–1.08); serum creatinine (AOR = 12.80, 95% CI 3.90–87.98) and low GFR (AOR = 9.50, 95% CI 4.05–22.28) were independently associated with greater odds for the presence of anemia CONCLUSIONS: Anemia is commonly present among diabetic adults attending our diabetes outpatient clinic in Northeast Ethiopia, including those without kidney disease. Our findings highlight the need for incorporating anemia screening into routine diabetes care to enable early detection and treatment of anemia and hence improve the overall care of patients with diabetes. Public Library of Science 2019-09-09 /pmc/articles/PMC6733511/ /pubmed/31498832 http://dx.doi.org/10.1371/journal.pone.0222111 Text en © 2019 Fiseha et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Fiseha, Temesgen
Adamu, Aderaw
Tesfaye, Melkam
Gebreweld, Angesom
Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia
title Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia
title_full Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia
title_fullStr Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia
title_full_unstemmed Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia
title_short Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia
title_sort prevalence of anemia in diabetic adult outpatients in northeast ethiopia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6733511/
https://www.ncbi.nlm.nih.gov/pubmed/31498832
http://dx.doi.org/10.1371/journal.pone.0222111
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