Abstract

Prevalence of Different Morphological Types of Anemia and Its Significance in Haemodialysis Patients: A Unicentric Study in a Tertiary Care Hospital

Background: Anaemia occurs in the early stages of kidney disease and worsens as kidney function deteriorates. Typical consequences of pneumonia are impaired erythropoietin production, iron and vitamin deficiency, blood loss, shortened erythrocyte life, chronic inflammation, and a uremic environment. Aim: To identify morphological classification of different types of anemia present in hemodialysis patients with chronic kidney diseases. Patients and methods: After obtaining informed consent, 4 mL of blood was collected from the vein of each participant for a Complete Blood Count (CBC) and peripheral film report. The CBC was performed using a haematology analyser. All these patients were previously diagnosed with chronic kidney failure and were on haemodialysis with an average duration of 4 years. They developed anaemia during their illness, so the patients were evaluated to find out the cause of the anaemia. Depending on haematological laboratory data, peripheral blood smear examinations of these 22 patients showed different morphological types of anemia. All patients were on baseline erythropoietin at 10,000 IU per week. Results: In this study, 30 patients were included, of whom 22 were anaemic: 14 males (59%) and 9 females (41%). The age range was 35–75 for males and 27–62 for females. The most common types of anemia were normochromic anaemia (50%), which developed in 11 patients, followed by hypochromic microcytic anaemia (31.81%), which developed in 7 patients, and macrocytic anemia (18.18%), which developed in 4 patients. Iron deficiency was notable found in microcytic anemia and also was seen in few cases of normocytic and macrocytic anemia also. Conclusion: Anemia from chronic diseases was the most frequent in hemodialysis patients. There are higher levels of inflammatory parameters in hemodialysis patients than in healthy controls. Normochromic anaemia was the most prevalent type, followed by microcytic hypochromic and then macrocytic hypochromic. Inflammatory markers were higher in most of the patients with normocytic normochromic relationships, with inflammation being the cause of EPO resistance.

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