University of Khartoum

Anaemia in Sudanese Patients with Chronic Renal Failure on Haemodialysis

Anaemia in Sudanese Patients with Chronic Renal Failure on Haemodialysis

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Title: Anaemia in Sudanese Patients with Chronic Renal Failure on Haemodialysis
Author: Elfakki, Sahar Siddig Ahmed
Abstract: Background: Chronic kidney disease (CKD) is a progressive loss of kidney function over a period of months or years.Almost all patients with end stage chronic kidney disease on haemodialysis are anaemic; and iron deficiency anaemia (IDA) is one of the most common causes of this anaemia.Iron deficiency anaemia in haemodialysis patients is caused by nutritional deficiency, reduced iron absorption and external blood loss. The aim of this study is to determine the frequency of anaemia especially IDA among renal failure patients on haemodialysis, and to assess the effect of the different modules of treatments on the Hb level, and correlate the results with the frequency of the follow up of these patients with a nephrologist. Methods: This was a prospective cross-sectional study, conducted at Omdurman Military Hospital from December2014 to April2015 that included one hundred patients with chronic renal failure on haemodialysis. Initial CBC was done for all the selected patients. Iron profile (serum iron, serum ferritin and total iron binding capacity) was done for those found to have hypochromic microcytic anaemiafrom this initial CBC. Those confirmed to have iron deficiency anaemia according to the iron profile testing were followed up monthly for the next three months to monitor their Hb level. Results: The studied population were 62 males (62%) and 38 females (38%), 66 patients were aged between 45-60 years(66 %). All the studied patients (100%) were found to be anaemic and their Hb level was less than 10 gm/dl. Thirty six patients had hypochromic microcytic anaemia (36%). Iron profile revealed iron deficiency in 28 patients (77.8%) of the hypochromic microcytic anaemia. Of these IDA patients; 10 patients (35.7%) were only on oral iron supplement, 9 patients (32.2%) used both iron supplements and erythropoietin, 4 patients (14.2%) used only injectable iron, 3 patients (10.7%) not on any type of treatment for IDA and 2 patients (7.2%) used only erythropoietin. Only 4 patients (14%) of IDA patients were on regular follow up with a nephrologist. There was a significant correlation between the Hb level and the age of the IDA patients (P= 0.04), and between the Hb level and the duration of haemodialysis (P=0.035).The Hb level and the follow up with a nephrologist revealed a significant correlation (P= 0.042).There was no significant correlation between the Hb level and the uses of the different modules of treatment (P= 0.74); and this was explained by the failure to interfere by changing to the effective type of treatment according to the patients’ result due to the poor follow up with a nephrologist. Conclusion Iron deficiency anaemia is common in patients with chronic renal failure on haemodialysis, and regular follow up with a nephrologist is important to monitor Hb level.
URI: http://khartoumspace.uofk.edu/123456789/25513


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