Hemostatic imbalances in chronic kidney disease: A regional perspective from Bihar

To evaluate platelet indices and basic blood coagulation parameters in various stages of CKD patients and to find out any correlation between patients' coagulation parameters and CKD staging.

It was a 2-year prospective observational study conducted in the Department of Hematology in a tertiary care hospital. Sample size was 160, out of which 80 were cases and 80 were age and gender matched controls. Patients of both sexes and age group ranging ≥20 years belonging to various stages of non-dialyzed CKD were included in the study. Platelet parameters studied were platelet count and platelet indices like Mean platelet volume (MPV) or platelet distribution width (PDW) and coagulation parameters studied were Prothrombin time (PT), International normalized ratio (INR), activated partial thromboplastin time (aPTT), Fibrin degradation products (FDP), D-dimer and fibrinogen.

The data obtained was be analyzed by using SPSS version 25 software. The results were expressed as the mean ± SD for continuous data and as percentage or frequency for categorical data.

The most common agegroup of CKD patients was found out to be 51-60 years (34.5%). Most common clinical feature with which patients presented to the clinic was weakness and lethargy (41.2%). Majority of the patients belonged to CKD stage III (51.2%) followed by CKD. The most common cause of CKD was diabetic nephropathy (33.1%), followed by hypertensive nephropathy (25.6%). Mean Platelet count was lowest in CKD stage 5 (0.96 ± 0.11 × 10³/μl). PDW showed a positive correlation with mean platelet count, suggesting a hyperproliferative kind of thrombocytopenia in CKD.

Monitoring of primary and secondary hemostatic parameters is of utmost importance in predicting bleeding and thrombotic risks in CKD patients.