Muhammad Iqbal Shah, Ramesh Kumar Suthar, Mukhtiar Ahmed Soomro.
CHRONIC KIDNEY DISEASE; Study on patterns of anemia in relation to glomerular filtration rate (GFR) in patients.
Professional Med J Jan ;22(09):1138-43.

Chronic kidney disease is usually related with anemia and the level of anemia correlates with the severity of renal failure. A chronic kidney disease is complicated by anemia and anemia may contribute to adverse clinical outcomes. No large-scale population data are available for patients with chronic kidney disease regarding prevalence of anemia, subpopulations at risk, and relationships between anemia and renal dysfunction. Objectives:The objective of this study is to determine the frequency of different patterns of anemia in relation to glomerular filtration rate in patients suffering from chronic kidney disease stage II and above patients.Material &Methods:Study Design: Cross sectional study. Setting: Medical and Nephrology wards of Liaquat University Hospital Hyderabad / Jamshoro. Period:20th January 2013 to 19thDecember 2013. Results: During the study period, total 339 patients of chronic kidney disease with stage II and above patients were enrolled. The mean age + Standard Deviation and range) of patients was 50.65 + 11.86 (16 to 80 years, n = 339). 211(62.2%) were male and 128(37.8%) were female. (Male to Female Ratio 1:6). Mean Hemoglobin + SD was 7.16 + 3.89 (3.0 to 17.0 g/dL). The frequency of anemia was present in 285(84.1%) patients with mean Hb+ SD 6.02 + 2.1 (g/dL). The mean weight + SD was 56.50 + 9.84 (40 to 81 kg). The mean serum creatinine + SD was 5.63 + 2.48 (0.9 to 12.0 mg/dL) and we observed that most frequent pattern of anemia was normocytic-normochromic anemia in 216(77.0%) patients, hypochromic-microcytic in 61(18.0%) and macroyctic in 17(5.0%) patients. We also found that as anemia increased progressively with declining GFR with mean hemoglobin concentration of 11.78 +2.8 g/dL in CKD stage 2, 10.14 + 3.6 g/dL in CKD stage 3, 6.8 + 3.6 g/dL in CKD stage 4, 7.44 + 4.0 g/dL in CKD stage 5. Conclusion: Frequency of anemia increases with the progression of stage of chronic kidney disease (decreased GFR) and anemia was most common in stage 5 patients of chronic kidney disease.Most frequent pattern of anemia is normocytic normochromic anemia.

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