Hematological profile in patients with chronic kidney disease in Pakistan: a cross-sectional research study

Abstract

Background Chronic kidney disease (CKD) is a leading global health threat. In Pakistan, age-specific prevalence of CKD is reportedly 43.6% among elderly (>50 years) and 10.5% among younger population (<30 years). A number of hematological parameters have been shown to be affected in patients with CKD and are associated with anemia, coagulopathy, and leukocyte dysfunction. The objective of the research study was to characterize the hematological profile identified in patients with CKD.Patients and methods In this cross-sectional study, 156 patients with end-stage renal disease (ESRD) were enrolled. Demographic details including age and sex and brief medical history were obtained. Medical records of the patients were also reviewed. In addition, upon obtaining written informed consent, venous blood sampling was performed by a professional phlebotomist, and results were acquired. The hematological profile was documented through predesigned proforma.Results The mean age of patients was 47.59±5.87 years. There were 114 (73.1%) male and 42 (26.9%) female patients in this study. Overall, 96 (61.5%) patients with ESRD had diabetes mellitus (DM), 89 (57.1%) had hypertension (HTN), and 65 (41.7%) had active smoking history. The average duration (months) of ESRD in patients was 15.5±2.4, mean hematocrit (%) was 23.8±3.2, hemoglobin (g/dl) was 8.7±3.1, erythrocyte sedimentation rate (ESR) (mm/h) was 94.2±43.2, platelet count (cells/l) was 147×109±65×109, white blood cell count (cells/l) was 7654.8±3947.4, neutrophil (%) was 67.3±14.6, lymphocyte (%) was 30.5±14.2, and eosinophil (%) was 6.2±2.2. The hematological profile also revealed that 144 (92.3%) patients had anemia, 128 (82.1%) had elevated ESR, 25 (16%) had thrombocytopenia, 30 (19.2%) had leukocytosis, and 19 (12.2%) had eosinophilia. When we stratified hematological profile of patients with ESRD regarding age, sex, DM, HTN, smoking status, and duration of ESRD, we found a significant correlation with respect to age (elevated ESR and thrombocytopenia), sex (anemia, elevated ESR, thrombocytopenia, and eosinophilia), DM (elevated ESR), smoking status (thrombocytopenia and leukocytosis), and duration of ESRD (thrombocytopenia and leukocytosis) (P<0.05). No relationship was witnessed between hematological abnormalities and HTN.Conclusion Our study demonstrated that anemia is a predominant clinicolaboratory manifestation in patients with CKD along with elevated ESR, thrombocytopenia, leukocytosis, and eosinophilia. A statistically significant correlation was observed between hematological abnormalities in patients with ESRD and age, sex, DM, smoking status, and duration of ESRD.