Characteristics of peripheral blood cells in patients with chronic renal failure at Thai Nguyen Central General Hospital

Abstract

Objective: To describe the characteristics of peripheral blood cells and analyze factors associated with changes in peripheral blood cell parameters among patients with chronic kidney disease (CKD) treated at Thai Nguyen Central General Hospital. Subject and method: A cross-sectional descriptive study was conducted on 116 patients with CKD. Hematological indices (RBC, HGB, HCT, MCV, MCH, MCHC, WBC, PLT), biochemical parameters (total protein, albumin, creatinine, urea, serum iron, and ferritin), and CKD stages were collected and analyzed to determine their relationships. Results: The mean age was 65.7 ± 13.9 years, with 72.4% aged ≥ 60 years. Anemia was present in 65.5% of patients, including 46.6% with moderate and 6.9% with severe anemia. Mean values of HGB (111.6 ± 24.3g/L), HCT (33.2 ± 7.4%), and RBC (3.88 ± 0.87T/L) were below normal reference ranges. Red cell indices - MCV (86.9 ± 8.6fL), MCH (29.0 ± 3.6pg), and MCHC (331.2 ± 32.1g/L) - were mostly within normal limits, indicating normocytic-normochromic anemia. HGB, HCT, and RBC levels were significantly lower in CKD stages IV - V compared with stages I–III (p<0.001), while MCV, MCH, MCHC, WBC, and PLT showed no significant differences. The severity of anemia correlated negatively with serum creatinine (r = -0.495) and positively with serum albumin (r = 0.379), suggesting that both progressive renal impairment and protein-energy wasting contribute to the pathogenesis of anemia. Conclusion: Anemia is a common and progressive complication of CKD, predominantly normocytic-normochromic, reflecting reduced erythropoietin production. Both declining renal function and malnutrition are associated with disease progression. Regular monitoring of HGB, albumin, and creatinine is essential for early detection and management of anemia in CKD patients.