Haematological profile of chronic kidney disease in a mixed-ancestry South African population : a crosssectional study
Date
2018-11
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Publishing Group
Abstract
Objectives The objectives were to characterise the
haematological profile of screen-detected chronic kidney disease (CKD) participants and to correlate the complete
blood count measures with the commonly advocated
kidney function estimators.
Methods The current cross-sectional study used data,
collected between February 2015 and November 2016,
of 1564 adults of mixed-ancestry, who participated in the
Cape Town Vascular and Metabolic Health study. Kidney
function was estimated using the Modification of Diet
in Renal Disease (MDRD) and Chronic Kidney Disease
Epidemiology Collaboration (CKD-EPI) equations. CKD
was defined as estimated glomerular filtration rate (eGFR)
<60 mL/min/1.73 m2, and anaemia as haemoglobin level
<13.5 g/dL (men) and <12 g/dL (women).
Results Based on the MDRD and CKD-EPI equations, the
crude prevalence of CKD was 6% and 3%. Irrespective
of the equation used, median red blood cell (RBC) indices
were consistently lower in those with CKD compared with
those without CKD (all p<0.0001). Despite not showing
any significant difference in total white blood cell (WBC)
count between the two groups, the number of lymphocytes
were lower (p=0.0001 and p<0.0001 for MDRD and CKDEPI,
respectively) and neutrophil count (both p<0.0297)
and the ratio of lymphocytes to neutrophil (both p<0.0001)
higher in the CKD group compared with those without
CKD; with the remaining WBC indices similar in the two
groups. The platelet count was similar in both groups.
Of the screen-detected CKD participants, 45.5% (MDRD)
and 57.8% (CKD-EPI) were anaemic, with the prevalence
increasing with increasing severity of CKD, from 37.2%
(stage 3) to 82.4% (stages 4–5). Furthermore, CKD-EPIestimated
kidney function, but not MDRD, was positively
associated with RBC indices.
Conclusion Though it remains unclear whether common
kidney function estimators provide accurate estimates
of CKD in Africans, the correlation of their estimates
with deteriorating RBC profile, suggests that advocated
estimators, to some extent approximate kidney function in
African populations.
Description
CITATION: George, C., Matsha, T.E., Erasmus, R.T. & Kengne, A.P. 2018. Haematological profile of chronic kidney disease in a mixed-ancestry South African population: a crosssectional study. BMJ Open 8(11):e025694. doi:10.1136/bmjopen-2018-025694.
The original publication is available at https://bmjopen.bmj.com/
The original publication is available at https://bmjopen.bmj.com/
Keywords
Kidney disease, Chronic kidney disease -- CKD, Kidney function, South African population, Mixed-ancestry, Cape Town Vascular, Metabolic health study, Chronic Kidney Disease Epidemiology Collaboration -- CKD-EPI, Modification of Diet in Renal Disease -- MDRD
Citation
George, C., Matsha, T.E., Erasmus, R.T. & Kengne, A.P. 2018. Haematological profile of chronic kidney disease in a mixed-ancestry South African population: a crosssectional study. BMJ Open 8(11):e025694. doi:10.1136/bmjopen-2018-025694.