Status of Some Haematological and Biochemical Parameters in Patients Diagnosed with Chronic Kidney Disease at Imo State Specialist Hospital, Umuguma, Owerri, Nigeria

Chronic kidney disease (CKD) is a prevalent global health challenge characterized by the progressive deterioration of renal function leading to significant metabolic, haematological, and cardiovascular complications.This study was aimed at evaluating the levels of red cell distribution width (RDW), mean platelet volume (MPV), white blood cell (WBC), serum creatinine, urea and albumin in patients with chronic kidney disease at Imo State Specialist Hospital, Umuguma, Owerri, Nigeria. A total of sixty (60) subjects were enrolled in the study and consisted of thirty (30) patients with chronic kidney disease and 30 age-matched apparently healthy subjects (controls). Ethical approval and informed consent were obtained from the ethics committee of the hospital and subjects respectively. Venous blood (7mls) was collected from the patients by venipuncture using sterile needles and syringes and dispensed into plain tubes (5mls) and ethylenediaminetetraacetic acid (EDTA) containers (2mls) immediately. The non-haemolysed samples in the plain tubes were centrifuged and separated and the serum samples were stored at -20°C prior to use, while the blood in the EDTA container was stored in the refrigerator at 4 °C. All reagents were commercially procured and the manufacturer’s standard operating procedures were strictly followed. Serum creatinine was determined using the Jaffe-Slot method, urea was determined using the diacetyl monoxime method, MPV and RDW and WBC were determined using haematology autoanalyser (Sysmex KX2IN while serum albumin was determined using the Bromocresol Green method. Values were presented as mean ± standard deviation (SD) and p<0.05 level of significance was adopted. All data obtained in the study were analyzed using the Statistical Package for Social Sciences (SPSS version 21). The mean values of urea (62.77±38.59)mg/dl, creatinine (2.72±2.27)mg/dl, RDW (52.12±8.42)fl, MPV (11.05±1.59)fl, WBC (10.25±4.02) cells/l were significantly in chronic kidney disease patients when compared to controls (18.10±6.08)mg/dl, (0.66±0.31)mg/dl, (43.46±8.97)fl, (8.63±0.93)fl and (5823.33±1969.89) cells/ul respectively (P=0.000) while albumin (3.34±0.93)mg/dl, was significantly lower when compared to controls (4.50±0.86)mg/dl (P=0.000). There was no significant difference in the mean values of urea (63.40±42.95)mg/dl, creatinine (3.09±2.85)mg/dl, albumin (3.05±0.77)mg/dl, RDW (52.1 l±6.78)fl, MPV (10.94±1.78)fl and WBC (10.40±4.59) cells/ul in males with chronic kidney disease when compared to that of the females (62.13±35.19)mg/dl, (2.34±1.49)mg/dl, (3.63±0.99)mg/dl, (52.13±10.04)fl, (11.17±1.44)fl and (10.09±3.52) cells/ul. There was no significant difference in the mean values of urea, creatinine, albumin, RDW, MPV and WBC in patients with chronic kidney disease when compared based on gender and age. There was a significant positive correlation of serum creatinine with urea in patients with chronic kidney disease (r= 0.64, p=0.000). There was a non- significant positive correlation of serum creatinine with albumin, RDW, MPV and WBC in patients with chronic kidney disease (r= 0.08, p=0.683; r=0.23, p=0.228; r=0.05, p=0.808 and r=0.38, p=0.039). Chronic kidney disease is associated with elevated levels of urea, creatinine, RDW, MPV, WBC and a significant decrease in albumin. Gender and age do not affect the levels of urea, creatinine, albumin, RDW, MPV and WBC in patients with chronic kidney disease. Therefore, we recommend that routine assessment of urea and creatinine should remain the cornerstone of CKD diagnosis and progression monitoring, and MPV, RDW and WBC should be assessed as part of cardiovascular risk evaluation, in routine blood tests for CKD patients to evaluate anaemia severity, and to detect systemic inflammation and its potential role in exacerbating CKD-related complications respectively.