Muhammad Hussain Baloch, Nadia Shams, Najia Mahmood, Warda Zahoor, Naresh Kumar Seetlani, Farhat Bashir.
End Stage Renal Disease; Hematological Profile in Geriatric End Stage Renal Disease Hemodialysis Cases.
Professional Med J Jan ;25(5):728-34.

Objectives: To study hematological profile in geriatric cases undergoing hemodialysis and compare with non-geriatric. Study Design: Descriptive Cross Sectional Study. Setting: Department of Nephrology & Medicine, Rawal Institute of Health Sciences Islamabad. Study Duration: 12 months (June 2016-June 2017). Material and Methods: Adult patients (>18years) diagnosed as end stage renal disease (ESRD), undergoing maintenance hemodialysis for >3 months included after ethical approval and consent. Group A had 88 geriatric ESRD cases (>65 years); group B had 88 non-geriatric (<65 years). Data analyzed by SPSS version 17. Hematological profile and other variables compared between two groups by Chi-Square and t-test (significant p<0.05). Results: Among 166 ESRD cases (69% males and 31% females), mean age was 54.9+10.6 years. Anemia present in 89% (group A) vs. 74% (group B; p=0.012). Mean hemoglobin was 8.57+2.00 (group A) vs. 9.27+2.39 (group B; p=0.035). Mean platelets count was lower among geriatrics; however leukocyte counts comparable between two groups. Mean eGFR was 7.95+2.68 (group A) vs. 9.16+4.04 (group B; p=0.020). Diabetes and hypertension were frequent in geriatric group (p<0.05). No difference in hepatitis B, C and congestive cardiac failure observed. BMI was 26.74+5.87 (group A) vs. 22.43+4.83 (group B; p<0.0001). Lack of social support observed in 25% (group A) vs. 9% (group B). Conclusion: Anemia is frequent observation in ESRD hemodialysis cases. Geriatric ESRD hemodialysis cases have significantly low hemoglobin levels than non-geriatric. Hence, suggested that old age to be considered as an additional risk factor for anemia in ESRD hemodialysis cases. Geriatric ESRD hemodialysis cases should undergo frequent anemia screening and timely intervention. Iron supplementation, dietary modification, erythropoietin administration and blood transfusion as per indication needs to be individualized in geriatric cases to improve hematological parameters and quality of life.

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