PMID- 30580276
OWN - NLM
STAT- MEDLINE
DCOM- 20191031
LR  - 20200309
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 8
IP  - 12
DP  - 2018 Dec 22
TI  - Anaemia among primary care patients with type 2 diabetes mellitus (T2DM) and 
      chronic kidney disease (CKD): a multicentred cross-sectional study.
PG  - e025125
LID - 10.1136/bmjopen-2018-025125 [doi]
LID - e025125
AB  - OBJECTIVES: This study aimed to determine the prevalence of anaemia among 
      patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) at 
      primary care settings and its associated factors. DESIGN, SETTING AND 
      PARTICIPANTS: This cross-sectional study involved 808 adult patients with T2DM 
      and CKD who were recruited via systematic sampling from 20 public primary care 
      clinics in Peninsular Malaysia. Their sociodemographic, clinical and biomedical 
      profiles were collected through interviews, examination of medical records and 
      blood testing. RESULTS: The prevalence of anaemia was 31.7% (256/808). The 
      anaemia was mainly mild (61.5%) and normocytic normochromic (58.7%). About 88.7% 
      of the patients with anaemia were not known to have anaemia prior to the study. 
      Among 36 patients with documented history of anaemia, 80.6% were still anaemic, 
      and only a half received iron therapy. Multivariate regression analysis showed 
      that women (adjusted odd ratio (AOR): 1.57, 95% CI: 1.12 to 2.21, p=0.009) and 
      those with older age (AOR: 1.04, 95% CI: 1.01 to 1.06, p<0.001), CKD stage 3a 
      (AOR: 2.47; 95% CI: 1.25 to 4.87, p=0.009), CKD stage 3b (AOR: 4.36; 95% CI: 2.14 
      to 8.85, p<0.001), CKD stage 4 (AOR: 10.12; 95% CI: 4.36 to 23.47, p<0.001), CKD 
      stage 5 (AOR: 10.80; 95% CI: 3.32 to 35.11, p<0.001) and foot complication (AOR 
      3.12, 95% CI: 1.51 to 6.46, p=0.002) were more likely to have anaemia. Having 
      higher body mass index (AOR 0.95, 95% CI: 0.92 to 0.99, p=0.012) and higher 
      diastolic blood pressure (AOR 0.97, 95% CI: 0.95 to 0.99, p<0.001) were 
      associated with lower odds to have anaemia. CONCLUSION: Anaemia among patients 
      with T2DM and CKD in primary care was common, and the majority was unrecognised. 
      Inadequate treatment of anaemia was also prevalent. Therefore, screening of 
      anaemia should be incorporated into the routine assessment of diabetic 
      complications particularly for those with significant associated factors. It is 
      hoped that such strategy could lead to early treatment and hence improve their 
      overall care. TRIAL REGISTRATION NUMBER: NMRR-15-660-24324.
CI  - (c) Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Idris, Iliza
AU  - Idris I
AD  - Klinik Kesihatan Ampangan, Jalan Seremban-Kuala Pilah, Seremban, Malaysia.
FAU - Tohid, Hizlinda
AU  - Tohid H
AD  - Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan 
      Malaysia, Kuala Lumpur, Malaysia.
FAU - Muhammad, Noor Azimah
AU  - Muhammad NA
AD  - Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan 
      Malaysia, Kuala Lumpur, Malaysia.
FAU - A Rashid, Mohd Radzniwan
AU  - A Rashid MR
AD  - Department of Family Medicine, Faculty of Medicine and Health Sciences, 
      Universiti Sains Islam Malaysia, Nilai, Malaysia.
FAU - Mohd Ahad, Azainorsuzila
AU  - Mohd Ahad A
AD  - Klinik Kesihatan Lukut, Jalan Seremban, Port Dickson, Malaysia.
FAU - Ali, Norsiah
AU  - Ali N
AD  - Klinik Kesihatan Masjid Tanah, Masjid Tanah, Malaysia.
FAU - Sharifuddin, Naemah
AU  - Sharifuddin N
AD  - Klinik Kesihatan Bandar Seri Putra, Kajang, Malaysia.
FAU - Aris, Junita Harizon
AU  - Aris JH
AD  - Klinik Kesihatan Batu 13 1/Jalan Hulu Langat, Selangor, Malaysia.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20181222
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Aged
MH  - Anemia/*epidemiology
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Malaysia/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Primary Health Care/*statistics & numerical data
MH  - Renal Insufficiency, Chronic/*complications/physiopathology
MH  - Risk Factors
MH  - Severity of Illness Index
PMC - PMC6307578
OTO - NOTNLM
OT  - anaemia
OT  - chronic kidney disease
OT  - diabetes mellitus
OT  - primary care
COIS- Competing interests: None declared.
EDAT- 2018/12/24 06:00
MHDA- 2019/11/02 06:00
PMCR- 2018/12/22
CRDT- 2018/12/24 06:00
PHST- 2018/12/24 06:00 [entrez]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2019/11/02 06:00 [medline]
PHST- 2018/12/22 00:00 [pmc-release]
AID - bmjopen-2018-025125 [pii]
AID - 10.1136/bmjopen-2018-025125 [doi]
PST - epublish
SO  - BMJ Open. 2018 Dec 22;8(12):e025125. doi: 10.1136/bmjopen-2018-025125.