Authors : Dr. Dumpa. Srinivasa Reddy; Dr. Srikar Bharadwaj; Dr. Ballipilli Mohith

Volume/Issue : Volume 9 - 2024, Issue 8 - August

Google Scholar : https://tinyurl.com/2jvz9mcd

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DOI : https://doi.org/10.38124/ijisrt/IJISRT24AUG1592

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Abstract : Aim: To assess the Haematological profile and Serum Iron indices in non-dialysis Chronic Kidney Disease patients  Background And Objectives: Anemia is one of the most common condition seen in patients with Chronic Kidney Disease. It occurs due to reduced production of erythropoietin from Kidney which is required for production of RBC. As many people are landing up with CKD and it is becoming a global issue, anemia is becoming more prevalent among the population. One of the factor which also contributes to it is nutritional deficiency such as iron deficiency anemia which overlaps with reduced production of RBC due to CKD.  Materials and Methods: It is a cross sectional study conducted over a period of 18 month in out patient department and wards of Department of Nephrology and General Medicine, Katuri Medical College and Hospital, Guntur. A sample size of 100 individuals were considered for the study. Ethical Clearances were taken and informed consent given about the same. Patients underwent needed investigations like haematological profile including Serum. Ferritin, Iron and transferrin saturation and Renal Function tests.  Results: Our study's findings indicated that the severity of chronic renal disease increased along with a low level of hemoglobin and packed cell volume. Anaemia was present in all the individuals included in the study cases. 70% of the individuals exhibited microcytic normochromic anemia, while 10% displayed microcytic hypochromic anemia. 10 percent of the studied subjects exhibited concurrent occurrences of both forms of anemia. The observed difference was very statistically significant (p = 0.0001). Among the Control patients, 32% had normal levels of haemoglobin, whereas the remaining 68% presented both kinds of anemia. There were significant differences (p < 0.05) in the TIBC, TSAT %, and Ferritin values between the study and control cases in terms of serum iron indices. The Ferritin readings did not show any significant differences.  Conclusion: It is imperative to make every possible attempt to determine the underlying cause of anemia in patients with chronic kidney disease (CKD) and to provide appropriate treatment for the concurrent iron deficient anemia in these individuals. Additionally, it is important to monitor other hematological parameters in order to identify any concomitant abnormalities.

References :

1. Go A et al: Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351:1296, 2004[PMID: 15385656]
2. Steven Fishbane: Haematologic Aspects of Kidney Disease, in Brenner & Rector's The Kidney, 8th ed, BM Brenner (ed). Philadelphia, Saunders, 2008, pp. 1728–1743.
3. National Kidney Foundation: K/DOQI clinical practice guideline for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis39[ 2 Suppl 1]:S1– S266,2002
4. Joanne M et al: Chronic kidney disease, in Harrison’s principles of internal medicine, 18th ed, Dan L.Longo(ed).2012, pp.2308-2321.
5. Ferguson JH, Lewis JH, Zucker MB: Bleeding tendency in uremia. Blood 1956; 11(12):1073-1076.
6. Escolar G, Diaz-Ricart M, Cases A: Uremic platelet dysfunction: past and present. Curr Hematol Rep 2005; 4(5):359-367.
7. Sarnak MJ Levey AS.cardiovascular disease and chronic renal disease. A new paradigm. American Journal Kidney Disease 2000;36:S117-131
8. National Kidney Foundation: KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease. Am J Kidney Dis 2006; 47(suppl 3):S1-S146
9. Eschbach JW et al Anemia of end stage renal disease kidney int 1985; 28:1
10. Mohanram A, Zhang Z, Shahinfar S, et al: Anemia and end-stage renal disease in patients with type 2 diabetes and nephropathy. Kidney Int 2004; 66(3):1131-1138
11. Anwer Salamath Khan et al; Managing anemia in End Stage Renal Disease. API medicine update volume 21, 2011:258-262
12. Wali RK, Henrich WL: Chronic kidney disease: A risk factor for cardiovascular disease. Cardiol Clin 2005; 23(3):343-362.
13. Keith DS, Nichols GA, Gullion CM: Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med 2004; 164:659-663
14. Lorell BH, Carabello BA: Left ventricular hypertrophy: Pathogenesis, detection, and prognosis. Circulation 2000; 102:470.
15. Abergel E, Tase M, Bohlender J, et al: Which definition for echocardiographic left ventricular hypertrophy?. Am J Cardiol 1995; 75(7):498-502.
16. Levin A, Thompson CR, Ethier J, et al: Left ventricular mass index increase in early renal disease: Impact of decline in hemoglobin. Am J Kidney Dis 1999; 34(1):125-134. 27.
17. Pickett JL, Theberge DC, Brown WS, et al: Normalizing haematocrit in dialysis patients improves brain function. Am J Kidney Dis 1999; 33(6):1122-1130.