An estimate of the size of the US predialysis population with renal insufficiency and anemia

Am J Kidney Dis. 1993 Mar;21(3):264-9. doi: 10.1016/s0272-6386(12)80744-x.


With the development of recombinant human erythropoietin, clinicians can now treat the anemia of chronic renal failure patients. Although most attention has focused on patients with end-stage renal disease, erythropoietin is also prescribed to anemic renal patients before the initiation of dialysis therapy. This study presents the first objective estimate of the size of the US population with predialysis renal insufficiency and the fraction of those patients who also have anemia. The study used population-based data from the second National Health Nutrition Examination Survey (NHANES II), conducted between 1976 and 1980. Participants underwent interviews, standardized physical examinations, and blood testing, including hematocrit and serum creatinine (N = 25,286 who were surveyed, 10,453 who underwent laboratory testing). Our estimates were based on the following methodology: (1) selecting predialysis renal insufficiency patients aged 12 to 74 years from the NHANES II survey, (2) adjusting for population changes between 1978 and 1988, (3) adding estimates for pediatric and geriatric populations, (4) projecting results to 1990, and (5) excluding nonanemic patients. The NHANES II survey included 44 patients with serum creatinine values greater than 2.0 mg/dL and less than 8.0 mg/dL. This yielded an estimate of 648,000 to 708,000 persons in 1990 with predialysis renal insufficiency. Data from both the NHANES II survey and the literature demonstrate that the percent of patients with anemia varies by serum creatinine level. All total, the study estimated that in 1990 there were between 68,000 and 75,000 individuals with predialysis renal insufficiency who also had anemia. However, several limitations of the methodology suggest that these values overestimate the true population numbers.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anemia / blood
  • Anemia / epidemiology*
  • Anemia / etiology
  • Child
  • Creatinine / blood
  • Female
  • Health Surveys
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Renal Dialysis
  • United States / epidemiology


  • Creatinine