Chronic kidney disease; study on patterns of anemia in relation to glomerular filtration rate [GFR] in patients

Chronic kidney disease is usually related with anemia and the level of anemia correlates with the severity of renal failure. A chronic kidney disease is complicated by anemia and anemia may contribute to adverse clinical outcomes. No large-scale population data are available for patients with chronic kidney disease regarding prevalence of anemia, subpopulations at risk, and relationships between anemia and renal dysfunction

Objectives: The objective of this study is to determine the frequency of different patterns of anemia in relation to glomerular filtration rate in patients suffering from chronic kidney disease stage II and above Patients

Material and Methods: Study Design: Cross sectional study

Setting: Medical and Nephrology wards of Liaquat University Hospital Hyderabad / Jamshoro

Period: 20[th] January 2013 to 19[th] December 2013

Results: During the study period, total 339 patients of chronic kidney disease with stage II and above patients were enrolled. The mean age +/- Standard Deviation and range] of patients was 50.65 +/- 11.86 [16 to 80 years, n = 339]. 211[62.2%] were male and 128[37.8%] were female. [Male to Female Ratio 1: 6]. Mean Hemoglobin +/- SD was 7.16 +/- 3.89 [3.0 to 17.0 g/dL]. The frequency of anemia was present in 285[84.1%] patients with mean Hb +/- SD 6.02 +/- 2.1 [g/dL]. The mean weight +/- SD was 56.50 +/- 9.84 [40 to 81 kg]. The mean serum creatinine +/- SD was 5.63 +/- 2.48 [0.9 to 12.0 mg/dL] and we observed that most frequent pattern of anemia was normocytic-normochromic anemia in 216[77.0%] patients, hypochromic-microcytic in 61[18.0%] and macroyctic in 17[5.0%] patients. We also found that as anemia increased progressively with declining GFR with mean hemoglobin concentration of 11.78 +/- 2.8 g/dL in CKD stage 2, 10.14 +/- 3.6 g/dL in CKD stage 3, 6.8 +/- 3.6 g/dL in CKD stage 4, 7.44 +/- 4.0 g/dL in CKD stage 5

Conclusion: Frequency of anemia increases with the progression of stage of chronic kidney disease [decreased GFR] and anemia was most common in stage 5 patients of chronic kidney disease. Most frequent pattern of anemia is normocytic normochromic anemia

Essential hypertension; [evaluation of serum uric acid at tertiary care hospital hyderabad/jaivishoro]

Little and sparse information is present in our population on association between serum uric acid and essential hypertension .Increased serum uric acid is related with elevated blood pressure in different research studies. The relationship between serum uric acid level and high blood pressure can be difficult to assess because drugs for high blood pressure usually affect uric acid level. The objective of our study is to evaluate the association of serum uric acid to severity and duration of essential hypertension at Liaquat University Hospital [tertiary care] Hyderabad / Jamshoro. Case control and prospective study. Medical wards and Out Patient Medicine Department of Liaquat University Hospital Hyderabad /Jamshoro. One year i.e. from 20[th] March 2013 to 19[th] February 2014. A total of 75 high blood pressure subjects aged 35 years and above were included as cases with same number[75] of age and sex matched normal blood pressure subjects as controls after excluding, Secondary hypertension, metabolic syndrome ,Diabetes Mellitus, age <40 ;>70 years, hypothyroidism, hyperparathyroidism, Ischemic heart disease, congestive cardiac failure, Alcohol abuse, Renal Insufficiency, glomerulonephritis, pyelonephritis, hereditary nephropathy, patients on drugs -, ethambutol levodopa pyrazinamide, low dose asprin, Cytotoxic drugs, nicotinic acid ,thiazide diuretics.. Qualitative and quantitative data were evaluated in SPSS version 16.0. The mean serum uric acid level was 6.3 +/- 1.4 mg/dl vs 4.5 +/- 1.2 mg/dl in case [n = 75] and control patients [n = 75] respectively. A total of 23 [30.6%, n = 75] patients in cases and 8 [10.6%] subjects in control had high serum uric acid [Odds Ratio 2.13, p <0.05]. Therefore, the frequency of increased serum uric acid level subjects and mean serum uric acid level were significantly greater in hypertensive cases, as compared to those of healthy normal blood pressure Controls. Serum uric acid correlated positively with both systolic blood pressure [r=0.132, p<0.01] and diastolic blood pressure [r=0.214; p<0.01]. High serum uric acid is frequent in our populace with essential hypertension and there is relationship between serum uric acid level and blood pressure. Further large scale research studies on the pathophysiologic significance of high serum uric acid in these high blood pressure patients are in further need