Haematological Indices and Iron Status in Pre-Dialysis Chronic Kidney Disease Patients

I. R. Edeki, E. I. Unuigbe, E. I. Okaka

Abstract

BACKGROUND: Chronic kidney disease (CKD) is associated with
haematological changes, the commonest being anaemia. The
number and function of white blood cells (WBC) and platelets are
equally affected. Iron deficiency is a common cause of anaemia in
the CKD population and anaemia has been associated with reduced
cardiac function, increased rates of hospitalization, morbidity and
mortality. This study aimed to determine the haematological indices
and iron status among pre-dialysis CKD patients.

METHOD: A hospital-based cross-sectional study involving 95 predialysis
CKD patients and 95 age- and sex-matched apparently
healthy controls. Full blood count, peripheral blood film, serum
ferritin, transferrin saturation, C-reactive protein (CRP), electrolytes,
urea and creatinine, serum folate and vitamin B12 were done in all
study participants. Comparisons were made between results
obtained from participants in both groups.

RESULT: The mean ages were 58.1 ± 14.9 years and 58.3 ± 15.0
years in the CKD group and controls, respectively. The male:female
ratio was 1:0.9 in both groups. The prevalence of anaemia was 51.6%
and 3% in patients with CKD and controls, respectively. There was
no significant difference in the total WBC count, neutrophil and
lymphocyte differentials, platelet count, serum vitamin B12 and
folate in patients with CKD and controls. The prevalence of iron
deficiency among patients with CKD was 32.6%, of which 62.5%
were absolutely iron-deficient while 37.5% were functionally irondeficient.
The median ferritin and CRP were also higher in CKD. (p
=0.001).

CONCLUSION: Anaemia and iron deficiency are common in predialysis
CKD patients. Early diagnosis and treatment are important
to avoid the problems associated with them.

KEYWORDS: Chronic kidney disease, Anaemia, Iron deficiency,
Pre-dialysis