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Background: Chronic Kidney Disease (CKD) can be defined as an estimated glomerular Filtration Rate (eGFR) of less than 60 ml/min/1.73 m2for a minimum period of three months. CKD is commonly associated with various hema-tological abnormalities especially anemia. Aim: The present study was planned to assess the hematological variations in CKD patients as compared to healthy subjects. Method: Fifty patients diagnosed with CKD were enrolled for the study. Fifty age and sex-matched healthy subjects constituted the control group. Blood samples were collected for all subjects enrolled in the study and subjected to analysis including complete blood count (CBC) using five parts cell counter and renal function test (RFT), including urea, creatinine using dry chemistry, and potassium using direct ion-selective electrode method. Result: On comparison of the hematological profile, it was observed that all enrolled CKD patients were anemic with hemoglobin (Hb) less than 13g/dL in males and less than 12 g/dL in females. The mean Hb levels were as low as 7.50 ± 1.55 g/dL (P< 0.0001). Correspondingly, total RBC count of CKD patients was also low. It was also observed that platelet count was slightly low among CKD patients. However, the mean level was compara-ble with control group (P=NS). On further analysis, it was observed that among fifty CKD patients, 46% (n=23) suf-fered from severe anemia i.e. Hb < 7 gm/dL, whereas 48% had moderate anemia i.e. Hb between 7-9.9 gm/dL. How-ever, only 12 % (n=6) CKD patients suffered from thrombocytopenia i.e. platelets count < 1.50 lack/cmm. Conclu-sion: Hematological abnormalities may lead to several associated morbidities and may pose a challenge for mainte-nance of overall health status for CKD patients. Hence, there is need to monitor hematological profile of CKD patients specially those on dialysis so that any abnormality can be detected and managed accordingly.
RESUMO
Introduction: CKD MBD remains a complex issue in elderlypatients that has yet to be clearly defined. We aimed to evaluatethe disturbances in mineral bone disease in newly detected,untreated stage 4 and 5 elderly chronic kidney disease patients.Material and Methods: A cross-sectional observational studywith total of 93 newly detected patients underwent clinicalevaluation, biochemical assessment [serum albumin, calcium,intact parathyroid hormone(iPTH), 25- hydroxyvitamin D,phosphorus, alkaline phosphatase(ALP), creatinine], BMDmeasurement by dual-energy X-ray absorptiometry(DXA)and Lateral Abdominal X ray for aortic calcification(AAC).Results: Symptoms related to CKD-mineral bone disorderwere seen in 33.6% of the study patients. Prevalence ofhypocalcemia, hyperphosphatemia, hyperparathyroidism,and hypovitaminosis D were 64.2%, 81.1%, 49.5%,and 89.5%, respectively. Prevalence and severity ofhyperphosphatemia, hyperparathyroidism, hypocalcemia andraised ALP increases from stage 4 to stage 5 CKD, whilehypovaitaminosis D is equally prevalent in both stages.Secondary hyperparathyroidism is most common form ofCKD MBD in untreated elderly CKD population. BMD byDXA showed a low bone mass in 26.81% of our patients atdistal forearm. Patients older than 75 years more commonlyhad osteoporosis, lower ALP, phosphorus and iPTH. AAC wasseen in 13.98% of study group. Patients with AAC had higherphosphorus, iPTH and ALP. Compared to non diabetic CKDpatients, lower levels of phosphorus, ALP and iPTH wereobserved in diabetic CKD patients.Conclusion: Our study shows CKD MBD is prevalent inelderly population where symptoms alone are not enough todiagnose the bone disease.