The haematological profile of Nigerians with chronic renal failure

In an attempt to add to existing sparse literature on the haematological profile in chronic renal failure (CFR) in Nigeria, we have undertaken a comprehensive haematological sturdy of 39 patients (male 27, female 12) age range 11-56 yr., (mean 28.8 +/- 11.8) who had established pre-dialytic CFR. The mean haematocrit was 24.1 +/- 6.7% (range 12-40%). Severe anaemia was found in seven (18%), mild to moderate anaemia in 27 (69%) whilst five patients were not anaemic. Haematocrit correlated inversely with the degree of renal failure as assessed by serum creatinine (r = -0.35, P < 0.05). Red cell morphology was variable but the majority of patients showed a normocytic, normochromic blood film. The reticulocyte counts/indices were low. The mean total white cell count was generally within normal limits, ranging from (2 to 10.5 x 10(9)/l), with a mean of 5.3 +/- 2.1 x 10(9)/l and striking eosinophilia in 5 patients. Platelet count ranged between 82 and 350 x 10(9)/l (mean 156.5 +/- 65.7 x 10(9)/l) with only 3 patients having a relatively low count of < 100 x 10/l. Prolonged bleeding time (BT) > 9 minutes occurred in 13 (25.6%). There was no significant correlation between platelet count and bleeding time r = 0.21, P = 0.34. No significant correlation was observed between serum creatinine and bleeding time r = 0.09, P > 05. The bone marrow showed predominantly normocellular marrow but 7 patients had hypocellularity. Myeloid: Erythroid ratio ranged between 1:1 and 10:1, (mean 3:6:1) and correlated positively with serum creatinine values. (r = 0.37, P = 0.048). Bone marrow storage iron was absent in two and reduced in six patients. Severe anaemia is a common feature in Nigeria patients with CRF and it strongly associated with the severity of the renal failure. The low reticulocyte count and the tendency for erythroid hpoplasia to occur with increasing severity of renal failure would necessitate the use of erythropietin in our patients. The increased bleeding tendency in some of the patients calls for caution in surgical procedures in these patient.