{"title":"Determinants of Anemia Among Patients with Chronic Kidney Disease: A Systematic Review of Empirical Evidence.","authors":"Prapatsinee Prapaiwong, Suebsarn Ruksakulpiwat, Pawitra Jariyasakulwong, Piyoros Kasetkala, Wimolrat Puwarawuttipanit, Kewalin Pongsuwun","doi":"10.2147/JMDH.S535423","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to identify and synthesize empirical evidence regarding determinants of anemia among patients with chronic kidney disease (CKD) to inform clinical management and guide future research.</p><p><strong>Methods: </strong>A comprehensive search of six electronic databases (PubMed, MEDLINE, ScienceDirect, Scopus, Web of Science, Google Scholar) was conducted for studies published from 2019 to 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists tailored to each study design, and data synthesis was performed using convergent thematic analysis.</p><p><strong>Results: </strong>Of 2269 records initially identified, 21 studies met inclusion criteria. Most studies originated from China (33.3%), employed cross-sectional designs (66.6%), and were hospital-based. Overall methodological quality was moderate to high, with JBI scores ranging from 69.23% to 100% (mean = 86.48%); notably, 47.6% of studies achieved a perfect quality score. Seven key themes emerged: 1) demographic and personal characteristics, 2) comorbidities, 3) duration of dialysis treatment, 4) kidney function, 5) biomarkers and metabolic ions, 6) geographic disparities, and 7) stimulation interventions (including stimulating agents, supplements, and exercise). Our review highlights that comorbidity (eg, diabetes mellitus, low BMI), declining kidney function, prolonged dialysis duration, and biomarkers such as calcium, phosphorus, ferritin, and inflammatory markers were significantly associated with anemia. Geographic disparities highlighted greater anemia prevalence in rural populations.</p><p><strong>Conclusion: </strong>This review underscores multifaceted determinants of anemia in CKD, emphasizing comprehensive assessment and targeted interventions. Future research should explore individualized strategies addressing these diverse factors.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3765-3780"},"PeriodicalIF":2.4000,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219152/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Multidisciplinary Healthcare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JMDH.S535423","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: This systematic review aimed to identify and synthesize empirical evidence regarding determinants of anemia among patients with chronic kidney disease (CKD) to inform clinical management and guide future research.
Methods: A comprehensive search of six electronic databases (PubMed, MEDLINE, ScienceDirect, Scopus, Web of Science, Google Scholar) was conducted for studies published from 2019 to 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists tailored to each study design, and data synthesis was performed using convergent thematic analysis.
Results: Of 2269 records initially identified, 21 studies met inclusion criteria. Most studies originated from China (33.3%), employed cross-sectional designs (66.6%), and were hospital-based. Overall methodological quality was moderate to high, with JBI scores ranging from 69.23% to 100% (mean = 86.48%); notably, 47.6% of studies achieved a perfect quality score. Seven key themes emerged: 1) demographic and personal characteristics, 2) comorbidities, 3) duration of dialysis treatment, 4) kidney function, 5) biomarkers and metabolic ions, 6) geographic disparities, and 7) stimulation interventions (including stimulating agents, supplements, and exercise). Our review highlights that comorbidity (eg, diabetes mellitus, low BMI), declining kidney function, prolonged dialysis duration, and biomarkers such as calcium, phosphorus, ferritin, and inflammatory markers were significantly associated with anemia. Geographic disparities highlighted greater anemia prevalence in rural populations.
Conclusion: This review underscores multifaceted determinants of anemia in CKD, emphasizing comprehensive assessment and targeted interventions. Future research should explore individualized strategies addressing these diverse factors.
目的：本系统综述旨在识别和综合慢性肾脏疾病（CKD）患者贫血决定因素的经验证据，为临床管理提供信息并指导未来的研究。方法：按照PRISMA （Preferred Reporting Items for Systematic Reviews and meta - analysis）指南，对2019 - 2024年发表的6个电子数据库（PubMed、MEDLINE、ScienceDirect、Scopus、Web of Science、b谷歌Scholar）进行全面检索。采用乔安娜布里格斯研究所（JBI）为每个研究设计量身定制的关键评估清单来评估方法学质量，并使用趋同主题分析进行数据综合。结果：在最初确定的2269项记录中，有21项研究符合纳入标准。大多数研究来自中国（33.3%），采用横断面设计（66.6%），并以医院为基础。总体方法学质量为中高，JBI评分范围为69.23% ~ 100%（平均为86.48%）；值得注意的是，47.6%的研究获得了完美的质量分数。出现了七个关键主题：1)人口统计学和个人特征，2)合并症，3)透析治疗持续时间，4)肾功能，5)生物标志物和代谢离子，6)地理差异，7)刺激干预（包括刺激剂，补充剂和运动）。我们的综述强调，合并症（如糖尿病、低BMI）、肾功能下降、透析时间延长以及生物标志物（如钙、磷、铁蛋白和炎症标志物）与贫血显著相关。地域差异突出了农村人口中较高的贫血患病率。结论：本综述强调CKD贫血的多方面决定因素，强调综合评估和有针对性的干预措施。未来的研究应该探索针对这些不同因素的个性化策略。
期刊介绍：
The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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