慢性肾病血液透析患者的临床病理相关性研究

P. Kumar M
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摘要

慢性肾脏疾病(CKD)是一个全球性的健康问题,与发病率和死亡率增加有关。血液透析是终末期肾脏疾病最常见的肾脏替代方式。血液学和生化参数的变化是CKD患者发病率和死亡率的主要因素。正态红细胞正色性贫血是CKD患者由于红细胞生成素缺乏而引起的典型形态。这些病理的早期发现和治疗可以提高CKD患者的生活质量。1)评价CKD血液透析患者的临床表现及各种病理改变。2)比较和关联CKD血液透析患者的各种临床病理参数,特别是糖尿病肾病。在CIMS医院进行为期一年十一个月的回顾性研究,包括50例CKD患者。记录完整的临床资料,并与各项血液学和生化指标进行对比。统计学分析采用卡方检验和学生T检验。在50例CKD患者中,86%为男性,年龄为41-50岁(62%)。最常见的合并症是高血压合并糖尿病,占44%。大多数患者(72%)血压在140-159mmHg之间。大多数(64%)CKD患者是已知的糖尿病病例。红细胞计数、血红蛋白、红细胞压积和血小板计数明显降低,常红细胞常色性贫血是最常见的形态类型。CKD患者WBC计数、ESR、血清尿素、肌酐和血清磷酸盐水平显著升高。与NDKD患者相比,DKD患者表现出显著的风险。慢性肾病是一种进行性、不可逆的疾病。我们发现各种血液学和生化参数的改变,与NDKD患者相比,DKD患者的改变更严重。早期认识和管理这些变化将对提高生活质量产生重要影响。
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Clinico-pathological correlation study in chronic kidney disease patients undergoing hemodialysis
Chronic Kidney Disease (CKD) is a global health problem and associated with increased morbidity and mortality. Hemodialysis is the most common mode of renal replacement in end stage kidney disease. Variation in hematological and biochemical parameters are the prime factors responsible for morbidity and mortality in CKD patients. Normocytic Normochromic Anemia is a typical morphology seen in CKD patients resulting due to erythropoietin deficiency. Early detection and treatment of these pathologies can improve the quality of life in CKD patients.: 1) To evaluate the clinical manifestations and various pathological changes associated with CKD patients on hemodialysis. 2) To compare and correlate various clinico-pathological parameters in CKD patients on hemodialysis, with special emphasis on diabetic kidney disease.: One year eleven months retrospective study was done at CIMS hospital, which included 50 CKD patients. Complete clinical data were recorded and correlated with various hematological and biochemical parameters. Statistical analysis was performed by chi square test and student’s T test. Out of 50 CKD patients, 86% were male, age group of 41-50 years (62%). The commonest co-morbidity was combined hypertension with diabetes in 44%. Majority (72%) had BP between 140-159mmHg. Most (64%) of the CKD patients were known cases of diabetes. Significantly lower levels of RBC count, hemoglobin, hematocrit and platelet count were found with normocytic normochromic anemia being the commonest morphological type. Significantly increased WBC counts, ESR, serum urea, creatinine and serum phosphate levels were noted in CKD patients. DKD patients showed significant risk compared to NDKD patients. CKD is a progressive, irreversible disease. We found alterations in various haematological and biochemical parameters, which were more severe among DKD patients compared to NDKD patients. Early recognition and management of these changes will have an important impact in improving the quality of life.
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