HEMATOLOGICAL PROFILE IN PATIENTS OF CHRONIC KIDNEY DISEASE WITH ITS SEVERITY IN A TERTIARY CARE HOSPITAL, NORTH ODISHA
Keywords:Chronic kidney disease, Anemia, Hemoglobin, Red blood count, Thrombocytopenia
Objective: Efforts can be made to normalize the hematological parameters and slow the progress of the disease so that the morbidity and mortality in these patients with chronic kidney disease could be effectively reduced.
Methods: The observational study was carried out in the Department of General Medicine, Pandit Raghunath Murmu Medical College Hospital, Baripada, between May 2018 and January 2019. Two hundred seventy patients of chronic kidney disease (CKD) above 15 years of age, satisfying the inclusion and exclusion criteria, were included in the study.
Results: In our study, 179 (66.30%) were male, and 91 (33.70%) were female with M:F of 1.97:1. The average age of the patients in the study was 55.72±12.77 years. About 42.59 % (115) of the patients were between 46 and 60 years of age. About 35.56% of CKD cases had determined etiology and, 64.44% of cases had unknown etiology. Hemoglobin, RBC, and packed cell volume were significantly lower in the patients with CKD compared to the controls (p=0.0001), and RDW was considerably higher in the patients with CKD compared to the controls (p=0.0001). Microcytic anemia was the most prevalent type of anemia. There was a hugely significant association between the prevalence of thrombocytopenia and the severity of CKD (p=0.006).
Conclusion: This study concluded that patients with CKD show abnormal hematological parameters. Evaluation of hematological parameters in these patients helps in classifying the type of anemia, aids in choosing the correct treatment modalities, and decreases mortality.
Bargman JM, Skorecki K. Chronic Kidney Disease in Harrison’s Principles of Internal Medicine. 20th ed., Vol. 2. New York: McGraw- Hill Publication; 2018. p. 2111-21.
Veerappan I, Abraham G. Chronic kidney disease: Current status, challenges and management in India. In Medicine Update. Mumbai: Association of Physicians of India; 2013. p. 593-7. Available from: http://www.apiindia.org/medicine_update_2013/chap130.pdf. [Last accessed on 2020 Jan 14].
Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, et al. Chronic kidney disease: Global dimension and perspectives. Lancet 2013;382:260-72.
K/DOQI; National Kidney Foundation. Clinical practice guidelines for anemia of chronic kidney disease. Am J Kidney Dis 2006;47 Suppl 3:S33-53.
Modi GK, Jha V. The incidence of end-stage renal disease in India: A population-based study. Kidney Int 2006;70:2131-3.
Agarwal SK, Dash SC, Irshad M, Raju S, Singh R, Pandey RM. Prevalence of chronic renal failure in adults in Delhi, India. Nephrol Dial Transplant 2005;20:1638-42.
Mani MK. Prevention of chronic renal failure at the community level. Kidney Int Suppl 2003;63:S86-9.
Mani MK. Experience with a program for the prevention of chronic renal failure in India. Kidney Int Suppl 2005;67:S75-8.
Mani MK. Nephrologist sans frontières: Preventing chronic kidney disease on a shoestring. Kidney Int 2006;70:821-3.
CKD Registry of India: Indian Society of Nephrology; 2020. Available from: http://www.ckdri.org. [Last accessed 2020 Apr 30].
Astor BC, Muntner P, Levin A, Eustace JA, Coresh J. Association of kidney function with anemia: The third national health and nutrition examination survey (1988-1994). Arch Intern Med 2002;162:1401-8.
Kaze FF, Kengne AP, Mambap AT, Halle MP, Mbanya D, Ashuntantang G. Anemia in patients on chronic hemodialysis in Cameroon: Prevalence, characteristics, and management in low resources setting. Afr Health Sci 2015;15:253-60.
Babbitt JL, Lin HY. Mechanisms of anemia in CKD. J Am Soc Nephrol 2012;23:1631-4.
Eschbach JW. The anemia of chronic renal failure: Pathophysiology and the effects of recombinant erythropoietin. Kidney Int 1989;35:134-48.
Besarab A, Ayyoub F. In: Schrier RW, editor. Anemia in Renal Disease. Diseases of the Kidney and Urinary Tract. 8th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2007. p. 2406-30.
Silverberg DS, Wexler D, Iaina A, Schwartz D. The correction of anemia in patients with the combination of chronic kidney disease and congestive heart failure may prevent the progression of both conditions. Clin Exp Nephrol 2009;13:101-6.
Keane WF, Brenner BM, de Zeeuw D, Grunfeld JP, McGill J, Mitch WE, et al. The risk of developing end-stage renal disease in patients with Type 2 diabetes and nephropathy: The renal study. Kidney Int 2003;63:1499-507.
Smith RE Jr. The clinical and economic burden of anemia. Am J Manag Care 2010;16:S59-66.
Mehdi U, Toto RD. Anemia, diabetes, and chronic kidney disease. Diabetes Care 2009;2:1320-6.
Van Nooten FE, Green J, Brown R, Finkelstein FO, Wish J. Burden of illness for patients with non-dialysis chronic kidney disease and anemia in the United States: Review of the literature. J Med Econ 2010;13:241-56.
Astor BC, Coresh J, Heiss G, Pettitt D, Sarnak MJ. Kidney function and anemia as risk factors for coronary heart disease and mortality: The atherosclerosis risk in communities (ARIC) study. Am Heart J 2006;151:492-500.
Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: A position statement from kidney disease: Improving global outcomes (KDIGO). Kidney Int 2005;67:2089-100.
World Health Organization. Hemoglobin concentrations for the diagnosis of anemia and assessment of severity. In: Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2011. Available from: http://www.who.int/vmnis/ indicators/hemoglobin. [Last accessed on 2020 Apr 30].
Kim S, Lim CS, Han DC, Kim GS, Chin HJ, Kim SJ, et al. The prevalence of chronic kidney disease (CKD) and the associated factors to CKD in urban Korea: A population-based cross-sectional epidemiologic study. J Korean Med Sci 2009;24 Suppl 1:S11-21.
Lightstone L, Rees AJ, Tomson C, Walls J, Winearls CG, Feehally J. High incidence of end-stage renal disease in Indo-Asians in the UK. QJM 1995;88:191-5.
Shastry I, Belurkar S. The spectrum of red blood cell parameters in chronic kidney disease: A study of 300 Cases. J Appl Hematol 2019;10:61-6.
Singh NP, Aggarwal L, Singh T, Anuradha S, Kohli R. Anemia, iron studies and erythropoietin in patients of chronic renal failure. J Assoc Physicians India 1999;47:284-90.
Poudel B, Yadav BK, Jha B, Raut KB, Pandeya DR. Prevalence and association of anemia with CKD: A hospital based cross-sectional study from Nepal. Biomed Res 2013;24:99-103.
Bueno CS, Frizzo MN. Anemia in chronic kidney disease in a hospital in the Northwest region to the state of Rio Grande do Sul. J Bras Nefrol 2014;36:304-14.
De Francisco AL, Stenvinkel P, Vaulont S. Inflammation and its impact on anemia in chronic kidney disease: From hemoglobin variability to hyporesponsiveness. NDT Plus 2009;2 Suppl 1:i18-26.
Elsayed AS, Azab AE. Correlation between chronic kidney diseases and hematological data in Tabatha hospital in Libya. Asian J Pharm Clin Res 2017;10:291-6.
Shittu AO, Chijioke A, Biliaminu SA, Makusidi AM, Sanni MA, Abdul-Rahman MB, et al. Hematologic profile of patients with chronic kidney disease in Nigeria. J Nephrol Ren Transplant 2013;5:2-10.
Arun S, Prabhu MV, Chowta KN, Bengre ML. The haematological pattern of patients with chronic kidney disease in a tertiary care set up in South India. J Clin Diagn Res 2012;6:1003-6.
Suresh M, Reddy NM, Singh MS, Bandi HK, Keerthi GS, Chandrasekhar M, et al. Hematological changes in chronic renal failure. Int J Sci Res Publ 2012;2:1-4.
Talwar VK, Gupta HL, Shashinarayan. Clinicohaematological profile in chronic renal failure. J Assoc Physicians India 2002;50:228-33.
How to Cite
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.