Inflammatory status as a contributor for anemia in patients with chronic kidney disease in Karbala, Iraq

Abstract

Objective In chronic kidney disease (CKD), there is primary deficiency of erythropoietin, thereby leading to anemia. In addition, chronic immune activation and the inflammatory process could be involved in the pathophysiology of anemia in patients with (CKD). However, anemia and inflammation are present in earlier stages of renal impairment. The objective of this study was to evaluate the possible association of some of the markers of inflammation with anemia in patients with CKD with and without dialysis treatment. Methods The markers of inflammation such as white blood cell (WBC) count, granulocytes % and C-reactive protein (CRP) were determined. Similarly, serum albumin, platelets count and hemoglobin level were measured in blood samples from 61 patients with CKD attending Nephrology Unit at Al-Hussein Medical City and 20 healthy controls. The selected patients were stratified into two subgroups; 31 patients without hemodialysis (HD) and other 30 patients on HD. Results A significantly lower hemoglobin level, serum albumin and platelets count were observed in patients with CKD on hemodialysis therapy compared to controls, (P value = 0.0001). There was a significant correlation between WBC count and granulocytes % with regard to the low hemoglobin level in patients with CKD especially those on hemodialysis HD, (P value < 0.05). Conclusion Renal failure anemia was found to be strongly associated with high WBC count and gronulocytes percentage which are known markers of inflammatory status.