Factors Leading To Severe Anaemia In Patients With Chronic Kidney Disease

Abstract

Objective: Chronic disease of the kidney (CKD) is a lethal malady that usually vitiates the function of the kidney.  It often stays unrecognized in the earlier stages but over time it may lead to end-stage renal disease (ESRD). CKD is linked to several complications, such as anaemia and infection which can augment the medical complexities. This study aimed to determine the factors leading to severe anaemia in predialysis CKD patients.

Methods: A Cross-sectional design was selected to conduct a study in the medicine ward at Abbasi Shaheed Hospital, Karachi from 20/08/23 to 20/08/24. Questions were asked about the duration of the CKD, diabetes mellitus (DM), and hypertension (HTN). A venous sample was collected for investigations including serum urea, creatinine, haemoglobin (Hb), hematocrit (Hct), blood urea nitrogen (BUN)and serum albumin level. Glomerular filtration rate (GFR) was calculated. Stages of CKD were classified as per NKF-K/DOQI classification. The information was entered on proforma and analysed through SPSS-23.0.

Results: Among 130 anaemic patients based on haemoglobin, 72 CKD patients had severe anaemia, mean Hb level of 6.59±0.96 g/dl, 49 patients had moderate anaemia with a mean Hb 8.98±0.73 g/dl and only 9 patients had mild type of anaemia, mean Hb 11.96±0.60 g/dl with significant p-value. (p-value=0.000) GFR was 12.00±6.94 ml/min/1.73m² in patients having severe anaemia, 17.20±9.82 ml/min/1.73m^2.in in individuals having moderate anaemia and 18.79±10.22 ml/min/1.73m² in CKD patients having mild anaemia. (p-value=0.001)

Conclusion: The severity of anaemia in advanced stages of CKD is a striking observation. There is a need for early diagnosis and management of kidney disease and nevertheless routine monitoring of kidney function especially in diabetic and hypertensive patients.

Keywords: Creatine, iron deficiency, diabetes mellitus, ocular hypertension, dialysis