Frequency of anemia in patients with increased level of parathyroid hormone among patients on maintenance hemodialysis.

Abstract

Objectives: One of the most frequently occurring complication of end stage renal disease is anemia. It can be defined as decrease in red blood cells with hemoglobin concentration less than 12 g/dl in women and less than 13 g/dl in men. Parathyroid hormone levels are also raised among patients with end stage renal disease to maintain serum calcium levels. The objective of this study is to evaluate the degree of anemia in patients with end stage renal disease currently on maintenance hemodialysis and have raised PTH levels. Study Design: Cross-sectional study. Setting: Kidney Center, Karachi. Period: November 2015 to July 2016. Material & Method: Patients undergoing maintenance hemodialysis during the study duration with PTH levels greater than 300 ng/L were included in the study. Patients with other co-morbid conditions like chronic liver disease and hypersplenism were excluded from the study. Results: The total number of patients on maintenance hemodialysis in the kidney center that matched our inclusion criteria was 110. Amongst them there were 47.3% (n=52) males and 52.7% (n=58) females. The mean age of patients in our study is 50.15 ± 12.92 years. The mean PTH level of patients was found to be 642 ± 405.9U. Since all the participants of the study are on maintenance dialysis, the mean duration of hemodialysis was found to be 4.2 ± 3.19 months. The mean hemoglobin level of patients was found to be 9.75 ± 1.47 g/dl. Conclusion: Patients with hyperparathyroidism and undergoing maintenance hemodialysis frequently develops anemia. Many factors account for this including raised PTH levels causing bone marrow fibrosis, decreased production of erythropoietin and resistance of produced erythropoietin are some factors responsible for the anemia.