Biomed Res- India 2013 Volume 24 Issue 1 99 Biomedical Research 2013; 24 (1): 99-103 ISSN 0970-938X Prevalence and association of anemia with CKD: A hospistal based cross- sectional study from Nepal. Bibek Poudel 1 , Binod Kumar Yadav 2,3 *, Bharat Jha 2 , Kanak Bahadur Raut 4 , Dipendra Raj Pandeya 5 1 Department of Biochemistry, Manipal College of Medical Sciences (MCOMS), Manipal Teaching Hospital (MTH), Pokhara, Nepal. 2 Department of Biochemistry, Institute of Medicine, Tribhuvan University Teaching Hospital (IOM, TUTH), Kath- mandu, Nepal. 3 Chombuk National university Hospital Research Institute of clinical Medicine,634-18 Geuman-dong,Deokjin-gu,Jeonju 561-712,South Korea 4 Department of Internal Medicine (Nephrology Unit), Institute of Medicine, Tribhuvan University Teaching Hospital (IOM, TUTH), Kathmandu, Nepal. 5 Department of Biochemistry, Nepalese Army Institute of Health Sciences- College of Medicine, Syanobharyang, Bhandarkhal, Kathmandu, Nepal . Abstract A hospital based cross-sectional study was conducted in department of biochemistry, Trib- huvan University Teaching Hospital (TUTH), Nepal. We showed the prevalence of anemia in chronic kidney disease (CKD) and association between anemia and CKD. Total of 163 predialysis patients in all stages of CKD and 163 of non-CKD healthy controls were en- rolled. CKD was defined and classified as per national kidney foundation guidelines. We analyzed biochemical profile on BT 2000 Plus biotechnica instruments - clinical chemistry analyzer and hematological profile on xs-1000i. Descriptive statistics and testing of hypothe- sis were used for the analysis using SPSS 16 software. The incidence of anemia in stage I, Stage II, Stage III, stage IV, stage V and all CKD were found to be 17.64%, 27.78%, 48.38%, 74.19%, 80% and 47.85% respectively. Hemoglobin level was significantly lower in CKD cases than non-CKD controls (P-value <0.001). 47.8% of CKD cases and 13.5% of non-CKD controls had anemia (Odds ratio 5.88, P-value <0.001). 41.3% of male CKD cases and 8.7% of male non-CKD controls had anemia (Odds ratio 7.39, P-value <0.001). 56.34% of female CKD cases and 13.5% of female non-CKD controls had anemia (Odds ratio 5.25, P-value <0.001). Anemia was seen in all stages of CKD. Prevalence of anemia increased as kidney function decreased. A strong association was found between an anemia and CKD. Keywords: anemia, chronic kidney disease, non-chronic kidney disease Accepted November 27 2012 Inroduction Chronic kidney disease is a worldwide public health prob- lem. Major outcomes of CKD include progression of CKD to end stage renal disease (ESRD), development of different complication due to impair kindney function and increased risk for development of cardiovascular disease (CVD) [1]. One of the common complications of CKD is the anemia which is associated with increased risk for cardiovascular disease (CVD), increased morbidity and mortality especially in high risk group [2]. Anemia is one of the nontraditional risk factor for CVD [3]. Develop- ment of anemia in CKD is basically due to complete or relative deficiency of erythropoiten. Besides erythropoi- etin deficiency, different factors including blood loss, decreased half life of red blood cells, iron deficiency, in- flammation etc may contribute to develop anemia in CKD [4]. Some studies reported that Hb-level start to decrease even early renal deficiency around 70 ml/min in male and 50 ml/min in female [5]. Furthermore, anemia in CKD aggravates the adverse outcomes in CKD and worsens the comorbidities of diabetes and hypertension [3].Early identification of anemia in CKD retards the development of end stage renal disease and consequently improves from CVD morbidity and mortality [6]. CVD is the lead- ing cause of mortality in patients having CKD and ac- counts of 58% patients dies from CVD in CKD [7]. Even mild form of renal insufficiency has been reported to be