Hematological and biochemical alterations and Iron Status in Patients with Chronic Kidney Disease and Hemodialysis: A Comparative Study from Southern Libya

Abstract

Chronic kidney disease (CKD) is a progressive systemic disorder associated with multiple hematological and biochemical abnormalities. This study aimed to evaluate hematological, biochemical and iron status in patients with chronic kidney disease and patients undergoing hemodialysis compared with healthy controls. A 120 participants divided into three groups: 30 healthy controls, 30 patients with CKD at different stages, and 60 patients with end-stage kidney disease undergoing hemodialysis. Complete blood count including hemoglobin (Hb), red blood cell count (RBC), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell count (WBC), and platelet count (PLT), Serum urea, creatinine, serum iron, and ferritin were measured. Both CKD and hemodialysis groups demonstrated marked hematological abnormalities compared with the control group. Hemoglobin, RBC count, and HCT were significantly reduced in both patient groups (P<0.0001), while MCV was significantly lower (P<0.0001) in the hemodialysis group, whereas MCHC, MCH showed no significant difference among the groups. Platelet counts were significantly lower in both patient groups, and WBC count was significantly lower in the hemodialysis group when compared with CKD group. There were also significantly increased urea levels in both patient groups and substantially elevated creatinine, particularly among hemodialysis patients (P<0.0001). Serum iron did not differ significantly among the groups, whereas ferritin levels were significantly elevated in both CKD and hemodialysis patients compared with controls. Conclusion: Patients with CKD, particularly those undergoing hemodialysis, exhibit significant hematological and biochemical abnormalities, with anemia being a prominent finding. Elevated ferritin levels may reflect altered iron metabolism and inflammation. Regular monitoring of hematological, biochemical, and iron-related parameters is essential for effective clinical assessment and management.