Publication:

Study of hematological profile in patients with chronic kidney disease

Background Chronic Kidney Disease (CKD) with its high prevalence, morbidity and mortality, has become an important public health problem. The incidence and prevalence of CKD is increasing worldwide, including India. CKD is associated with a variety of hematological abnormalities, include anaemia, infections and bleeding diathesis. Anaemia is the most consistent hematological abnormality and is associated with poor quality of life and poor cardiovascular outcomes.

Methods A hospital based cross-sectional observational study was done to detect the prevalence of haematological abnormalities, correlation of anaemia with CKD stage and evaluation of iron deficiency. Newly diagnosed CKD (stages 3 to 5) patients were included in this study. Presence of anaemia (Hb%, haematocrit, MCV, peripheral smear), iron deficiency (TSAT, serum ferritin), thrombocytopenia, leucocyte count and coagulation abnormalities (PT, APTT) in different stages of CKD were studied.

Results All the subjects in study group had anaemia which was normocytic and normochromic and of moderate degree in most patients. The severity of anaemia progressed with stage of the disease. Iron deficiency was significantly prevalent (52% in the study population, with transferrin saturation (TSAT) <20%). WBC count was not significantly altered. There was mild thrombocytopenia in a few patients. Bleeding time or other in vitro tests of platelet function were not measured. The coagulation parameters, PT and APTT, were not significantly altered.

Conclusions All CKD patients should be screened for iron deficiency anaemia for its early treatment and to decrease morbidity.