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
