Hematological Changes in Patients of Chronic Renal Disease and Their Response to Treatment with Erythropoietin

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Hematological Changes in Patients of Chronic Renal Disease and Their Response to Treatment with Erythropoietin

Naghmi Asif*, Sadaf Hasan**and Khalid Hassan*
Islamabad Medical & Dental College Islamabad,
*Department of Pathology, **Department of Physiology

Abstract
Introduction: Anemia is a common manifestation of chronic kidney disease, especially when the glomerular filtration rate falls below 30 ml/min. For evaluation of anemia, it is important to exclude other causes of anemia such as iron and other hematinic deficiencies, chronic inflammation or the effect of drugs. After reversible causes of anemia are excluded, supplementary erythropoietin (EPO) can be considered when the patient’s haemoglobin concentration falls below 11 g/dl.
Methodology: This prospective study was conducted at Nephrology unit of Holy Family Hospital Rawalpindi, from April- June 2014. Fifty diagnosed patients of chronic kidney disease presenting with anemia were included in the study. Their CBC was done on Sysmex KX21 to check their baseline parameters. About 4000 iu of EPO was administered subcutaneously to all patients for three weeks and CBC was done at the start of 4th week. Results were entered on SPSS version 17 for further analysis. P value of < 0.05 was taken as statistically significant. Results: Total number of cases included during the study period was 50. Their age range was between 13-68 years with the mean age of45.1+1.64 SD. Among these 28 (56%) were males and 22 (44%) were females. Changes in hematological parameters in CKD patients were noted. Notable changes were seen only in Hemoglobin levels. Mean Hemoglobin before the start of treatment was 8.10gms/dl + 0.107SD whereas after treatment mean hemoglobin increased to 8.93 + 0.100 SD with highly significant p value of 0.000. MCH also showed a significant improvement with a mean MCH (before treatment) 31.43 + 0.048 SD to mean MCH of 31.73+0.058 (after treatment) with a significant p value of 0.000. Changes in other hematological parameters were insignificant. Conclusion: Among hematological parameters hemoglobin is the most commonly affected. Erythropoietin plays an effective role in increasing hemoglobin level in these patients. Key words: Erythropoietin, Chronic kidney disease, Chronic renal failure, Hematological parameters, anemia.

         

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