The spectrum of red blood cell parameters in chronic kidney disease: A study of 300 cases

• Main Authors: Indira Shastry, Sushma Belurkar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Journal of Applied Hematology
• Subjects: Anemia; chronic kidney disease; red blood cells
• Online Access: http://www.jahjournal.org/article.asp?issn=1658-5127;year=2019;volume=10;issue=2;spage=61;epage=66;aulast=Shastry

AIMS: To analyze various changes in the red blood cell (RBC) parameters in patients with chronic kidney disease (CKD) and to correlate it with the stage of the disease. MATERIALS AND METHODS: The following parameters were analyzed in 300 diagnosed cases of CKD: RBC count; hemoglobin (Hb); hematocrit; mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); MCH concentration (MCHC); serum iron profile (serum total iron, total iron-binding capacity, and serum ferritin levels); and peripheral smear, blood urea, and serum creatinine levels. The data were retrieved from the laboratory information system, and SPSS version 20 was used for statistical analysis. RESULTS: The mean age of presentation was 52 ± 14 years. The male-to-female ratio was 4.3:1. The mean RBC count was 3.29 ± 0.79 × 106/μl, and a significant fall was noticed as the stage of CKD progressed. 74% and 60% of patients with Stage 4 and 5 CKD, respectively, showed Hb of <10 g/dl. Correlation of MCV, MCH, and MCHC values with stages of CKD was statistically not significant. One hundred and six (59%) patients had anemia of chronic disease as per the serum iron profile. 94% of patients showed normocytic normochromic RBC picture on peripheral smear and 21% showed features of hemolysis. CONCLUSION: Anemia is a leading cause of morbidity in patients with CKD and it worsens with the stage of the disease. Evaluation of Hb and RBC parameters in patients with CKD helps in classifying the type of anemia and aids in choosing the correct treatment modalities and avoids unnecessary iron overload in these patients.