Hematological and Biochemical Parameters in Chronic Hemodialysis Patients Attending the Teaching Hospital, Karapitiya

Abstract

Background: Chronic kidney disease (CKD) is an overriding health problem. End stage renal disease (ESRD) is characterized by irreversible and progressive destruction of renal function. ESRD patients, undergoing chronic dialysis are at risk of developing anaemia due to toxic uremic environment. The acid base status and removal of uremic substances by hemodialysis may impact the properties of blood cells. Objectives: To analyze the hematological and biochemical parameters in chronic hemodialysis patients attending Dialysis Unit, Teaching Hospital, Karapitiya Methods: This cross-sectional study included 77 ESRD patients on regular hemodialysis. Socio demographics, drug history and dialysis duration were obtained. Retained pre dialysis blood samples, haematology and biochemical test reports were collected. Fifty-nine Leishman-stained blood smears were examined. Morphological changes were scored using ICSH recommendations. Statistical analysis was done using SPSS version 25.0. Results: Sample included 50 males and 27 females. Among them 48.1% had 24 hours/month dialysis duration. All the patients were anaemic. There was no significant correlation between hemoglobin concentration and the duration of hemodialysis (p=0.137). From the total, 54.24% of blood smears had echinocytosis, 5.08% had target cells, 28.8% and 10.2% had high amount of cell shrinkage and cell fragmentation, respectively. There was a significant correlation between cell shrinkage and the hemodialysis duration (p=0.007), cell fragmentation and the hemodialysis duration (p=0.022). Of the sample, 22.08% had low serum Na+ levels. There was no significant correlation between serum Na+ level and hemodialysis duration (p=0.438). Out of sample, 27.27% of patients had high serum K+ levels. There was a significant correlation between serum K+ levels and the hemodialysis duration (p=0.029). Conclusions: Comparable to previous studies the patients in this study showed abnormalities in haematological parameters. The majority of the patients were moderately anaemic and showed normochromic – normocytic blood smears. Majority had normal levels of serum Na+ and K+. Regular assessment of haematological, biochemical parameters and red cell morphology is crucial in the management of ESRD. Keywords: Anaemia, Chronic Kidney Disease, Hemodialysis, Hemodialysis duration