Comparative Assessment of Iron Deficiency Anaemia among Chronic Kidney Disease Subjects in Niger Delta Nigeria

Abstract

Iron Deficiency Anaemia which is reduced red blood cells due to iron deficiency had been reported to be a major challenge among Chronic Kidney Disease patients. The cause of anaemia in these patients is multifactorial, ranging from the inability of the kidneys to excrete hepcidin to even the inability of the kidneys to produce erythropoietin. This study aimed at comparatively assessing IDA between CKD and APHS in Niger Delta. A total of 88 subjects were recruited, 55(62.50%) CKDP and 33(37.50%) Control subjects. Samples were collected and analysed for IDA Indicators  such as Serum Hepcidin Levels using commercial DRG Hepcidin-25 kit and other Haematological Indices using Automation (Sysmex KX-21N Automated Haematology Analyzer), Leishman Staining Technique and Supravital Staining Technique; Questionnaire was also used to obtain some data,  data obtained were analysed using SPSS version 21.The mean values for  Serum Hepcidin, Haemoglobin(HB), Packed Cell Volume(PCV), Red Blood Cell count(RBC), Mean Cell Volume(MCV), Mean Cell Haemoglobin(MCH), Mean Cell Haemoglobin Concentration(MCHC), Reticulocyte count(Retics) and Red Cell Distribution Width(RDW) were 52.00ng/ml, 10.00 g/dL, 31.00%, 3.74×102/L, 78.84fL, 26.58pg, 31.79g/dL, 0.64%, and 14.94% respectively in the CKD patients while that for the APHS were 16.00ng/ml, 14.00g/dL, 42.00%, 4.69×1012/L, 89.37fL, 29.59pg, 33.00g/dL, 1.09% and 13.20% respectively. Statistical T-Test of significance revealed that Serum Hepcidin level was elevated significantly in CKD patients (52.00ng/ml) when compared with APHS(16.00ng/ml) t86= 6.54, p<0.05, Haemoglobin value of 10.00g/dL in CKD patients was significantly lower than 14.00g/dL in APHS (t86 = -8.49, p<0.05), and the values of other haematological indices were lower except RDW that was elevated significantly among CKD patients when compared with the APHS (p<0.05) all at significance  level of 0.05. The elevated serum hepcidin and RDW level seen in this study  may be as a result of diminished renal clearance and inflammatory state of the kidney. The kidney”s inability to make enough erythropoietin may have lead to the low red blood cell count that consequently caused anaemia in subjects studied..The estimation of Serum Hepcidin level in CKD patients in addition to the other Haematological indices will improve the diagnosis, treatment and management of Iron Deficiency Anaemia in these patients.