Khan Mohammad N, Elderdery Abozer
College of Applied Medical Science, Aljouf University, Saudi Arabia.
Department of Haematology, Faculty of Medicine and Health Sciences, University of El Imam El Mahdi, Sudan.
J Hematol. 2018 Jan;7(1):1-6. doi: 10.14740/jh367w. Epub 2017 Jan 10.
Anemia results from low kidney production of the erythropoiesis-stimulant erythropoietin. Good liver function is crucial to patients with chronic kidney disease (CKD). This study analyzed two hematological parameters (hemoglobin (Hb) and hematocrit (Ht)) and two liver enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in patients with CKD undergoing hemodialysis (HD).
Three hundred and thirty individuals participated in this study. Of them, 159 patients with CKD undergoing HD and 171 healthy individuals as a control group were recruited between January and October 2017. Blood was collected into EDTA containers for complete blood count (CBC) and into additive plain containers for ALT and AST. Relevant case history data were also taken.
Obtained results for first and second month of Hb, Ht, AST and ALT of CKD patients undergoing HD were lower (10.2 g/dL and 8.9 for Hb; 27.2% and 24.8% for Ht; 17.8 IU/L and 15.6 IU/L for ALT; 13.9 IU/L and 12.0 IU/L for AST, respectively) (P < 0.05) compared to healthy individuals (15.1 g/dL for Hb; 44.6% for Ht; 28.3 IU/L for ALT and 23.0 IU/L for AST). Furthermore, Hb, Ht, AST and ALT levels were significantly lower (P < 0.05) in their second month compared to the first month.
Anemia might emerge in CKD patients because of low Hb concentration and consequent low Ht. Advanced stage CKD causes decreased AST and ALT, as a result of lipid metabolism disturbances. Therefore, anemia and liver diseases are recommended to be treated in CKD patients to alleviate related complications. Renal transplantation must be performed earlier for them to avoid further complications.
贫血是由于肾脏产生促红细胞生成的促红细胞生成素不足所致。良好的肝功能对慢性肾脏病(CKD)患者至关重要。本研究分析了接受血液透析(HD)的CKD患者的两项血液学参数(血红蛋白(Hb)和血细胞比容(Ht))以及两种肝酶,即丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)。
330人参与了本研究。其中,2017年1月至10月招募了159例接受HD的CKD患者和171名健康个体作为对照组。将血液采集到用于全血细胞计数(CBC)的EDTA容器中,以及用于ALT和AST检测的无添加剂普通容器中。还收集了相关的病史数据。
接受HD的CKD患者第一个月和第二个月的Hb、Ht、AST和ALT检测结果均低于健康个体(Hb分别为10.2 g/dL和8.9 g/dL;Ht分别为27.2%和24.8%;ALT分别为17.8 IU/L和15.6 IU/L;AST分别为13.9 IU/L和12.0 IU/L)(P < 0.05)(健康个体Hb为15.1 g/dL;Ht为44.6%;ALT为28.3 IU/L;AST为23.0 IU/L)。此外,与第一个月相比,他们第二个月的Hb、Ht、AST和ALT水平显著降低(P < 0.05)。
CKD患者可能因Hb浓度低以及随之而来的Ht低而出现贫血。晚期CKD由于脂质代谢紊乱导致AST和ALT降低。因此,建议对CKD患者进行贫血和肝脏疾病的治疗,以减轻相关并发症。必须尽早为他们进行肾移植,以避免进一步的并发症。