Haematological Changes in Predialyzed and hemodialyzed Chronic Kidney Disease patients in Libya

Abstract

Chronic kidney disease (CKD) is an emerging public health problem worldwide, with increasing cost of healthcare particularly in third world nations like Libya. Hematological parameters are generally influenced in CKD and the effect increases with the stage of CKD. Hematological profiles are rarely investigated in CKD subjects in our population. This study was conducted to determine the hematologic profile in Libyan CKD subjects and to compare it in both hemodialyzed and pre-dialyzed patients. The study included 55 hemodialyzed CKD patients, 50 pre-dialyzed CKD patients, and 48 healthy controls. Blood Samples were analyzed for urea, creatinine, and complete blood counts including hemoglobin concentration, red blood cells (RBCs), white blood cells (WBCs) and platelets count. The data were statistically analyzed using SPSS. Our results revealed that hypertension was the most common cause of CKD among the studied group. A significantly lower (p< 0.05) RBCs count, hemoglobin levels (Hb), and hematocrit in CKD patients than healthy controls. Platelet count was lower (p< 0.05) in hemodialyzed CKD patients than predialyzed CKD subjects. WBC count showed no significant change in CKD patients compared to control. The prevalence of anemia among hemodialyzed-CKD was markedly high (96% and 100% for males and females respectively) and double that of the predialyzed CKD patients (53% and 52% for males and females respectively). Estimated glomerular filtration rate showed a significant positive correlation with hemoglobin (Hb) concentration but non-significant correlations with other hematological parameters. These hematological abnormalities expose CKD patients to higher risk of anemia-related complications and bleeding disorders, and the risk increase with the stage of CKD, which may have a role in increasing the rate of patient mortality and morbidity. Moreover, hypertension as the most common cause of CKD in our study, this may indicate the lack management programs for blood pressure in hypertensive patients