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Anaemia in Chronic Kidney Disease (CKD) is multifactorial. Some of these factors include reduced production of erythropoietin by the kidneys, reduced absorption of iron in the gut and uraemic environment. These has led to increased need for blood transfusion until the introduction of Erythropoiesis stimulating agents and intravenous iron. The aim of the study is to observe the effect of Erythropoietin (EPO), Iron therapy, blood transfusion, and frequency of dialysis on hematocrit of chronic kidney disease (CKD) patients on non-standard maintenance hemodialysis therapy.
This is a retrospective study involving 21 CKD patients on maintenance hemodialysis (HD). Data were extracted from their files at LASUTH Hemodialysis Unit which included biodata, aetiology of CKD, frequency of HD, duration on HD, monthly dose of EPO and Iron therapy and hematocrit level on commencement of Maintenance hemodialysis and the latest hematocrit at the time of collating data. Patients were stratified into three groups based on the parameters listed in Table 1. Fisher’s exact test was used to assess for differences between the groups.
Total 21 patients were recruited after informed written consent, out of which 13 were males. Most common etiology for CKD were Hypertensive nephrosclerosis (38%), Chronic Glomerulonephritis (24%) and Diabetic kidney disease (19%) respectively. The comparison of different therapies and effect on final hematocrit has been depicted in Table 2.
Appropriate dosing of Erythropoietin reduces the need for blood transfusion. Larger prospective study will be needed to further assess the effect of EPO, iron therapy and frequency of dialysis on hematocrit of CKD patients on maintenance hemodialysis at our centre.