SPECTRUM OF BONE MARROW CHANGES IN PATIENTS OF CHRONIC KIDNEY DISEASE (STAGE III, IV AND V)

Advanced Stage Chronic Kidney Disease

Abstract

Objective: To see the various hematological changes in the bone marrow of patients with chronic kidney disease (CKD) stage III, IV and V.
Study Design: Cross sectional observational study.
Place and Duration of Study: Study was conducted in the department of haematology (Pathology), Army
Medical College, Rawalpindi and duration was one year, from Mar 2015 to Feb 2016.
Material and Methods: Patients of both sexes and all age groups with CKD stage III, IV and V were included in this study. Patients’ histories were recorded. Complete blood counts, bone marrow aspiration and trephine biopsy were done and evaluated microscopically. Mean blood counts of the patients in three groups of CKD were compared. Frequencies of various bone marrow (BM) findings in patients of CKD were calculated.
Results: Out of 57 patients, 41 (71.9%) were males while 16 (28%) were females. Mean age was 60 years. There was no statistically significant difference between the mean hemoglobin, mean white cell count and mean platelets count of the patients in three groups of CKD. Reactive changes due to underlying CKD and
inflammation were the most frequent findings in the BM of the patients.
Conclusion: Anaemia of mild to moderate severity and reactive changes in the BM are the most frequent
haematological findings encountered in patients suffering from advanced stage CKD. Since CKD is predominantly a disease of the elderly so it is not rare to find the co-morbidities including plasmacytosis,
malignancies and their effects on the BM in patients of CKD.