During 2001–March 2020, the overall crude prevalence of anemia increased from 4.9% to 7.1%. Anemia prevalence was at least 2.6 times higher among adults with CKD compared to adults without CKD across the time periods. Crude prevalence of anemia among adults with CKD was higher among older, female (except 2013-2016), and non-Hispanic Black adults.
To view the burden of Anemia by risk categories, select from the drop-down menu below. Risk categories include CKD, Age Category, Sex, and Race/Ethnicity.
Data includes CKD stages 1–5. Estimates were standardized to the 2010 U.S. Census adult population.
Estimate for Race\Ethnicity "Other" was suppressed due to a large standard error stemming from a small sample size.
NHANES is a nationally representative, cross-sectional survey that is currently conducted every two years (since 1999) by CDC's National Center for Health Statistics among noninstitutionalized US civilian residents. The survey consists of a standardized in-home interview and a physical examination with blood and urine collected at a mobile examination center. Data were examined by combining two NHANES cycles to represent four-year periods from 2001 to 2016 and the 2017–March 2020 pre-pandemic cycle.
Note: Not all NHANES variables are collected for all years; therefore, some NHANES indicators may not utilize the full 20-year span.
Overall: Prevalence of anemia among U.S. adults.
By strata: Prevalence of anemia among U.S. adults with CKD.
National Health and Nutrition Examination Survey (NHANES).
Noninstitutionalized U.S. adults aged ≥ 18 years, pregnant women excluded.
2001–March 2020.
Overall: U.S. adults aged ≥ 18 years with anemia.
By strata: U.S. adults aged ≥ 18 years with CKD and anemia.
Overall: U.S. adults aged ≥ 18 years with data for CKD and anemia.
By strata: U.S. adults aged ≥ 18 years with CKD (eGFR < 60 ml/min/1.73 m2 or albuminuria) and data for anemia
CKD is defined by an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m² or albuminuria (urine albumin to creatinine ratio [UACR] ≥ 30 mg/g). Estimates are based on single estimates of eGFR and UACR.
Based on the CKD-EPI (2021) equation for calibrated creatinine: eGFR=142 x [min(serum creatinine in mg/dL) /κ, 1)]^α x [max(serum creatinine/κ, 1)]^-1.20 x 0.9938^age x (1.012 if female). κ = 0.7 if female and 0.9 if male α = -0.241 if female and -0.302 if male
UACR was calculated as urine albumin divided by urine creatinine. Albuminuria is defined as UACR ≥ 30 mg/g. Urine albumin is measured in random urine collection by fluorescent immunoassay.
Anemia was defined as hemoglobin levels less than 13 g/dL in males and less than 12 g/dL in females.1
Serum creatinine values used for eGFR calculation were standardized against isotope dilution mass spectrometry (IDMS).
Estimates were standardized to the 2010 U.S. Census population for adults: 18–39 years: 37.1%, 40–59 years: 38.1%, 60–69 years: 12.8%, and 70+ years: 12.0%.
Albuminuria and kidney function were assessed from one-time cross-sectional measurements, possibly overestimating CKD prevalence.
Appropriate NHANES survey weights were used for all analyses; if relative standard error is greater than 30%, the estimates are not shown. Serum creatinine measurements are assay corrected for NHANES years 2005 and 2006 and prior to be combined with later years.
AGA Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia. Ko, Cynthia W. et al. Gastroenterology, Volume 159, Issue 3, 1085 – 1094.
