Hematological Profile in Patients of Chronic Kidney Disease in a Tertiary Care Centre in South India

Abstract

Background: Chronic kidney disease has increased rapidly in the world, especially in developing countries like India,due to increase in Diabetes mellitus, Hypertension etc.Besides, symptomatology in such patients, laboratory parameters like Hematological, Biochemical etc are important in establishing diagnosis in such patients. Often, importance is paid to Biochemical parameters and Hematological parameters are neglected.Hematological parameters play a pivotal role in prognosis of these patients. Aim: The main aim of this study is to assess the hematological parameters in patients of Chronic Kidney disease and to assess their effect post dialysis. Materials and Methods: This is a cross sectional study done on 64 patients of chronic kidney disease and on maintenance of dialysis. The study was carried out in Hematology section of Central Laboratory, Mahatma Gandhi Medical College and Research Institute,Pondicherry from January to July 2020. Results: Out of 64 patients of Chronic Kidney disease, 47 (73.4%) patients were males and 17 (26.5%) patients were females. Majority of the patients were from the age group 41–60 years (76.5%), followed by the age group 21–40 years (18.7%). The major cause of Chronic Kidney disease was patients suffering from both Diabetes mellitus and hypertension accounting to 63 %, followed by Diabetes mellitus alone 25% and Hypertension alone 12%. (Graph 1) The hematological parameters before and after dialysis were anaemia, otherwise other parameters were within normal limits. The peripheral smear examination of all these patients, out of which 52(81.2%) patients showed Normocytic Normochromic anaemia and 12 (18.7%) patients showed (Graph 2) Microcytic hypochromic anaemia. Peripheral smear examination of Normocytic Normochromic anaemic patients showed evidence of hemolysis post dialysis in 28 patients. 12 patients showed fragmented red blood cells(schistocytes) alone, 7 patients showed microspherocytes alone and 9 patients showed both fragmented red blood cells and microspherocytes. Peripheral smear picture was more or less similar pre and post dialysis,except the parameters improved after the dialysis. Conclusion: Chronic kidney disease is a serious health ailment, which requires careful monitoring of all the parameters, not merely the kidney function tests, but also the hematological parameters, which affect the prognosis of the condition of the patient.