Pattern of haematologic abnormalities in incident dialysis patients and the effect of using locally derived haematologic reference ranges

Abstract

Background: The aim of the study was to compare the prevalence of haematologic abnormalities seen in incident haemodialysis patients using standard laboratory reference ranges with reference ranges derived locally.

Study Design and Method: This was a retrospective study of 97 patients with renal failure who received haemodialysis at a single dialysis unit in Lagos, Nigeria. All patients were 18 years of age or older, had renal failure requiring dialysis, and had not previously dialyzed. Patients with a history of haemoglobinoapthy or other red cell disorders, recent history of overt blood loss or blood transfusion and pregnancy were excluded.

Results: Fifty six (57.7%) of the patients were males; and 55 (56.7%) had chronic kidney disease. There were no significant differences in baseline characteristics between males and females, however, patients with CKD had significantly higher mean systolic and diastolic blood pressures, mean serum creatinines and lower mean haemoglobin concentrations.

Overall, anaemia was the most common haematologic abnormality (97.9%), followed by leukocytosis (34.0%). Leukopenia, thrombocytosis and thrombocytopenia were less common (3.1%, 7.2% and 10.3% respectively). The use of locally derived reference ranges was associated with significantly higher frequencies of occurrence of majority of the haematologic abnormalities studied.

Conclusion: Haematological abnormalities occurred frequently in the study population. Use locally derived haematologic reference ranges was associated with significant differences in the frequency and pattern of some of the haematologic abnormalities. Further studies are needed to determine the clinical implications of these findings.

Keywords: Haematologic abnormalities; chronic kidney disease; acute kidney injury; dialysis