Changes in Tissue Erythropoietin and Some Haematological Parameters in Chronic Kidney Disease Subjects on Blood Transfusion in Port-Harcourt

Abstract

Chronic kidney disease (CKD) is a progressive loss in renal function over a period of time. The kidney chiefly secretes erythropoietin (EPO) which is a glycoprotein hormone that acts on the bone marrow cells resulting in red blood cell formation. Anaemia is a major complication in CKD. The aim of this study was to assess changes in erythropoietin levels in chronic kidney disease patients on blood transfusion attending health care in Port Harcourt. A total of one hundred and fifty two (152) subjects were recruited for this study. One hundred and twenty two (122) subjects were recruited from those confirmed with renal diseases from the Urology Department of the hospital. Thirty eight (38) subjects were non-transfused with blood and eighty four (84) subjects were multitransfused with blood. Thirty subjects were apparently healthy controls. EPO was determined by sandwich ELISA method while the full blood count was determined using haematology autoanalyser, Mindray BC-6800..The results were statistically analyzed using GraphPad prism version 5.0 and statistical significance set at P<0.05. The result showed a significant decreased (p<0.0001) in EPO level in multitransfused and non-transfused subjects with mean values of 4.95±2.95 mIU/Land 6.32±2.66 mIU/L respectively compared to control 10.51±3.05 mIU/L. On assessment of the haematological characteristics, erythropoietin secretions of patients with chronic kidney disease (CKD), the mean haematocrit, haemoglobin, mean cell haemoglobn concentration and red cell count for the multiple transfused CKD were respectively found to be significantly lower compared to that of nontransfused. This could be due to impaired erythropoietin secretion and other factors which suppress marrow erythropoiesis  and shortened red cell survival in CKD which was directly associated with a decrease in red cell count and subsequent reduction in the haematocrit level. Transfusion improves anaemia through the increase in haemoglobin and hepcidin and as well suppresses erythropoiesis with an eventual decrease in erythropoietin and growth differentiation. It is therefore concluded that transfusion does not improve anaemia in CKD subjects.