HAEMATOLOGIC PARAMETERS OF PATIENTS WITH CHRONIC KIDNEY DISEASE IN ZARIA

Abstract

Introduction: Chronic kidney disease is a global health problem with an increasing number of
renal replacement transplants. Anaemia is a known complication of CKD of which its indicators
have not been adequately studied in Nigeria.
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Aims and objectives: This study aims to determine the level of basic and special haematologic
indices as well as to evaluate the relationship between such indices and CKD in ABUTH Zaria.
Materials and Methods: It was a cross-sectional descriptive study of 91 adult patients with CKD
in ABUTH. The haematologic parameters studied between July and September 2014 include Hb,
TWBC, Platelet, Reticulocyte count, red cell indices, ESR, sEpo, sTfR, and serum ferritin.
Results: There were 51 (54.90%) and 40 (45.10%) females and males respectively. Majority of
the participants, 59.34% were diagnosed with CKD at ≥45 years of age. Hypertensive disorders
and/or diabetes mellitus were the major causes of CKD being 50.54%, 19.78% and 6.59%
respectively. The mean Hb of all CKD patients was 10.97±2.81g/dl. The anaemia was
normocytic, normochromic with mean MCV, MCH, and MCHC within normal limits
(83.31±8.74fl, 28.34±3.12pg, 34.11±4.93g/dl respectively). Mean TWBC, platelet count, RDWCV, reticulocyte count, ESR, serum ferritin, sTfR, and sEpo were 6.63±2.79×109/l, 256±98.71×109/l, 16.29±3.69%, 3.18±4.07, 40.11±37.76mm in 1st hour,70.58±46.44µg/ml,
22.9±49.7µg/ml, and 12.49±33.47IU/L respectively. Following gender stratification there was no
significant difference in the mean weight (69.51±17.73Kg male, 63.92±15.13Kg female, p-value
0.11). Prevalence of anaemia was higher in males (80.49%) than female (62.00%) with a
significant positive trend of anaemia in CKD (Chi square for trend 11.888, p-value 0.001). There
was a positive correlation between sTfR and sEpo (r=0.7, p-value 0.001, r˄2= 0.96), a negative
correlation between stage of CKD and Hb (r=-0.339, p-value 0.001, r˄2= 0.43), also between Hb
and ESR (r=-4.198, p-value 0.004, r˄2= 0.10). ESR, Hb, and TWBC showed significant variability
with stage of CKD (Kruskal-Wallis 0.012, 0.001, and 0.018 respectively). However other
parameters show no significant relationship and association.