A study of hematological profile in CKD patients who are undergoing hemodialysis in a tertiary health care institute

Abstract

The complete blood count, peripheral blood smear, bleeding time, clotting time and renal function tests of 114 patients of chronic renal failure who had required hemodialysis for a period of at least 3 months prior to the commencement of this study were studied. The purpose of this study was to investigate the derangements in the haematological profile of chronic renal patients undergoing hemodialysis and to correlate the same with the duration and severity of the renal failure. The principal finding in the study was a 100% prevalence of anemia among chronic renal failure patients, which was predominantly of the normocytic normochromic type. Red blood cell count was reduced in nearly all (93%) of study patients. There was also a strong negative correlation (r = -0.74) between haemoglobin and duration of hemodialysis. However, a significant proportion of cases showed abnormal cells in the peripheral blood cells such as burr cells, schistocytes and pencil cells, suggesting other contributing factors to the anemia. Female patients also showed a significantly greater prevalence of increased red cell distribution width (>15%) as compared to males (p = 0.001) and a lower prevalence of normocytic normochromic anemia as compared to males (p = 0.009). White blood cell counts, platelet counts, and bleeding and clotting times were largely within normal limits, and none of these variables showed a statistically significant association with the duration of hemodialysis, or serum creatinine, or serum blood urea nitrogen. The inference from the study is that anemia is a major comorbidity in end-stage renal failure patients, with many factors contributing to it, and detailed workup and effective treatment of anemia is necessary in this group of patients.