Hematological and biochemical alterations across stages of chronic kidney disease: a tertiary care based observational study

Abstract

Background: Chronic kidney disease (CKD) is associated with progressive hematological and biochemical abnormalities that increase morbidity and mortality. Anemia, electrolyte imbalance, metabolic acidosis, and inflammation worsen with declining renal function. Objectives were to describe the hematological and biochemical profile of CKD patients; to compare parameters between early (stages 1-3) and advanced CKD (stages 4-5); and to assess correlations between glomerular filtration rate (GFR) and selected laboratory variables.

Methods: This observational study included 380 adults with CKD stages 1-5 attending a tertiary care hospital. Data collected included demographics, body mass index (BMI), CKD stage, and laboratory parameters (hemoglobin, blood cell counts, serum creatinine, uric acid, electrolytes, calcium, bicarbonate, GFR, C-reactive protein (CRP), and blood urea nitrogen). Anemia was graded as severe (<8 g/dL), moderate (8-9.9 g/dL), mild (10-10.9 g/dL), or absent (≥11 g/dL). Independent-samples t-tests compared CKD stages 1-3 vs 4-5, and Pearson’s correlation assessed associations with GFR (p<0.05).

Results: Most patients were male, aged 41-60 years, and stage 5 CKD constituted over half of the cohort. Nearly 40% were overweight or obese. Anemia affected almost three-quarters of patients, with severe and moderate anemia seen in approximately one-fifth and one-third, respectively. Advanced CKD showed significantly lower hemoglobin, calcium, and bicarbonate, and higher creatinine levels. GFR correlated positively with hemoglobin, calcium, and bicarbonate, and negatively with creatinine and CRP.

Conclusions: CKD patients exhibited a high burden of anemia, metabolic acidosis, hypocalcemia, and inflammation, worsening with disease progression. Early identification and management of these abnormalities may improve outcomes.