Assessment of the Haematological changes Post-haemodialysis Among Saudi Renal Failure Patients

Abstract

Renal failure is a situation in which the kidney fails to function adequately. There are two forms of renal failure: acute and chronic renal failure. End- Stage Renal Disease is the final stage of chronic renal failure were in there is a progressive, irreversible deterioration in renal function and function is substituted by renal replacement therapy, haemodialysis (HD), peritoneal dialysis (PD), or transplantation. During HD, patients’ blood comes in direct contact with the dialysis membrane non physiological environment which may elicit a series of changes in the blood cells and in haemostasis. The aim of this present study was to assess the changes in various hematological parameters that may occur in renal failure patients post-HD, to determine the differences between various hematological parameters that occur in renal failure patients pre and post–HD compared to a control group. The possible effect of dialysis duration on hematological parameters that may occur in renal failure patients was also investigated. The resulting data from these studies might help the clinicians to initiate precautions before and after a dialysis session. The study included a healthy control group of 60, consisting of 30 males and 30 females. The control group was age, sex and race matched with the patients group of 100 renal failure patients undergoing HD, and consisting of 61 males and 39 females. Blood samples from these patients were collected before and after dialysis sessions. The samples were tested for complete blood count, differential count, prothrombin time (PT) ,activated partial thromboplastin time (APTT) and fibrinogen. The results of the present study revealed that the most of the hematological parameters measured in HD patients, pre- or post-HD were either elevated or lowered when compared to a Control group. Furthermore it was noticed that most of the hematological parameters increased after HD session. More significantly PT, APTT and fibrinogen were found to increase post-HD while there was a concurrent decrease of platelets counts. A significant positive correlation was noticed between the time period the patients have been on dialysis and each of fibrinogen, APTT and PT levels. However there was a significant negative correlation between the time period the patients have been on dialysis and platelets count. Therefore, it is recommended that all patients be screened appropriately before and after dialysis to avoid complications.