Study of Peripheral Smear Findings in Patients with Chronic Kidney Disease in a Tertiary Care Centre

Abstract

 Introduction: Chronic kidney disease (CKD) is a progressive disorder associated with significant hematological and biochemical alterations, particularly anemia, thrombocytopenia, and proteinuria. Peripheral smear examination, though simple and cost-effective, provides valuable insights into morphological spectrum of anemia and other blood abnormalities in CKD patients. This study aimed to evaluated the peripheral smear findings and correlate them with clinical and biochemical parameters in patients with CKD.

Material & Methods: A cross-sectional study was conducted on 98 patients diagnosed with CKD at tertiary care centre. Detailed demographic, clinical, biochemical data were collected. Peripheral smear analysis was performed to assess red blood cell (RBC) morphology, leukocyte variations, platelet abnormalities. Serum urea, creatinine, and urine albumin were also evaluated to correlate hematological findings with renal function status.

Results: The study population had a male predominance (60.20%) and most patients were aged 51–75 years (68.37%). Hypertension (39.80%) and diabetes mellitus (36.73%) were the leading comorbidities. Normocytic normochromic anemia was the most common finding (69.39%), followed by microcytic hypochromic anemia (7.14%). Thrombocytopenia was present in 35.71% of cases. Leukocyte abnormalities included neutrophilia (14.29%) and toxic granulations (8.16%). Biochemically, 94.90% of patients had elevated urea levels (>40 mg/dL), and 86.73% had creatinine levels between 1.2–8 mg/dL; 13.27% exceeded 8 mg/dL. Albuminuria was present in over 90% of patients, with 44.90% having 2+ proteinuria.

Conclusion: The predominance of normocytic normochromic anemia and significant platelet and leukocyte abnormalities highlight the hematological burden of CKD. Elevated urea, creatinine, proteinuria confirmed advanced renal dysfunction. Peripheral smear remains an inexpensive yet powerful diagnostic tool, offering critical insights into disease severity and aiding timely interventions. Integrating smear analysis with standard renal function tests can improve CKD management, particularly in resource limited settings.