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Open Access February 07, 2023

Prevalence of Anemia and Variations of Hematological Parameters among Anemic Hemodialysis Patients in the Tripoli Region

Abstract Background: Prolonged decline in the ability of the kidney to regulate acid–base balance, eliminate waste products, and manage water homeostasis and entered chronic phase, toxic metabolic accumulates and erythropoietin secretion by the kidney is decreasing and causes hematological changes including decrease of HCT, MCV, RBCs and platelet counts. Hemodialysis became a practical treatment for kidney failure and is the most common method used to treat advanced and permanent kidney failure. Anemia is one of the most common complications in hemodialysis patients. Objectives: The study aimed to evaluate the prevalence of anemia among hemodialysis patients and investigate the variations of hematological parameters among anemic hemodialysis patients in the Tripoli region. Materials and Methods: The present study was conducted on 250 renal failure patients, attending Tripoli Center for dialysis and 100 normal healthy subjects. The study Ethical Committee of the medical centers and the Libyan Academy of graduate studies reviewed and approved the study design and patient consent statements were taken from each patient. Information's about the patients were recorded in a questionnaire. A blood sample of 5 ml was drawn by venous puncture from each normal healthy individual and hemodialysis patient. 2.5 ml of the blood sample was collected in K-EDTA tubes for the hematological examinations and another 2.5 ml of the blood sample was collected in a plain tubes for biochemical tests (serum urea, creatinine, and uric acid concentrations). The hematological parameters (RBCs count, Hb, HCT, MCV, MCH, MCHC, WBCs count, differential count of WBCs, and Platelets count) were determined using an automated hematology analyzer Sysmex (K- 4500) machine. The data were compared using GraphPad Prism version.9. The statistical significance of differences between groups was evaluated with the independent t-test. A P-value of <0.05 was considered significant for all statistical tests. Results: The results showed that the prevalence of anemia among hemodialysis patients was 89.8%. The degrees of anemia were 17% severe, 71.66% moderate, and 11.34% mild anemia. The types of anemia were 13.36% microcytic hypochromic, 82.59% normocytic hypochromic, and 4.05% macrocytic hypochromic anemia. RBCs, WBCs & platelets counts, Hct, MCHC, and Lymphocytes % showed a significant (P<0.01) decrease, and MCV was a significant (P<0.01) increase in the anemic hemodialysis patients compared with the healthy individuals. But, a significant (P<0.05) decrease in MCH was observed in the anemic hemodialysis patients when compared with the healthy individuals. A significant correlation was observed between RBCs and their indices with most of the hematological parameters. A significant (P<0.01) negative correlation was observed between serum urea with Hb, and RBCs count and Hct. While, a significant (P<0.01) positive correlation was recorded between uric acid with platelets count. A significant (P<0.05) positive correlation was observed between gender with platelets count, while, a significant negative correlation was recorded between gender with serum urea (P<0.01), creatinine, and uric acid, and Hb (P<0.05). A significant (P<0.01) negative correlation was observed between blood groups with serum uric acid. A significant (P<0.01) positive correlation was observed between durations of hemodialysis with RBCs count and Hb, while, a significant (P<0.05 [...] Read more.
Background: Prolonged decline in the ability of the kidney to regulate acid–base balance, eliminate waste products, and manage water homeostasis and entered chronic phase, toxic metabolic accumulates and erythropoietin secretion by the kidney is decreasing and causes hematological changes including decrease of HCT, MCV, RBCs and platelet counts. Hemodialysis became a practical treatment for kidney failure and is the most common method used to treat advanced and permanent kidney failure. Anemia is one of the most common complications in hemodialysis patients. Objectives: The study aimed to evaluate the prevalence of anemia among hemodialysis patients and investigate the variations of hematological parameters among anemic hemodialysis patients in the Tripoli region. Materials and Methods: The present study was conducted on 250 renal failure patients, attending Tripoli Center for dialysis and 100 normal healthy subjects. The study Ethical Committee of the medical centers and the Libyan Academy of graduate studies reviewed and approved the study design and patient consent statements were taken from each patient. Information's about the patients were recorded in a questionnaire. A blood sample of 5 ml was drawn by venous puncture from each normal healthy individual and hemodialysis patient. 2.5 ml of the blood sample was collected in K-EDTA tubes for the hematological examinations and another 2.5 ml of the blood sample was collected in a plain tubes for biochemical tests (serum urea, creatinine, and uric acid concentrations). The hematological parameters (RBCs count, Hb, HCT, MCV, MCH, MCHC, WBCs count, differential count of WBCs, and Platelets count) were determined using an automated hematology analyzer Sysmex (K- 4500) machine. The data were compared using GraphPad Prism version.9. The statistical significance of differences between groups was evaluated with the independent t-test. A P-value of <0.05 was considered significant for all statistical tests. Results: The results showed that the prevalence of anemia among hemodialysis patients was 89.8%. The degrees of anemia were 17% severe, 71.66% moderate, and 11.34% mild anemia. The types of anemia were 13.36% microcytic hypochromic, 82.59% normocytic hypochromic, and 4.05% macrocytic hypochromic anemia. RBCs, WBCs & platelets counts, Hct, MCHC, and Lymphocytes % showed a significant (P<0.01) decrease, and MCV was a significant (P<0.01) increase in the anemic hemodialysis patients compared with the healthy individuals. But, a significant (P<0.05) decrease in MCH was observed in the anemic hemodialysis patients when compared with the healthy individuals. A significant correlation was observed between RBCs and their indices with most of the hematological parameters. A significant (P<0.01) negative correlation was observed between serum urea with Hb, and RBCs count and Hct. While, a significant (P<0.01) positive correlation was recorded between uric acid with platelets count. A significant (P<0.05) positive correlation was observed between gender with platelets count, while, a significant negative correlation was recorded between gender with serum urea (P<0.01), creatinine, and uric acid, and Hb (P<0.05). A significant (P<0.01) negative correlation was observed between blood groups with serum uric acid. A significant (P<0.01) positive correlation was observed between durations of hemodialysis with RBCs count and Hb, while, a significant (P<0.05) negative correlation was recorded between durations of hemodialysis with body weight, and MCHC. Conclusion: It can be concluded that a higher prevalence of moderate, normocytic hypochromic anemia among hemodialysis patients. Also, results showed a significant variation in hematological parameters among the anemic hemodialysis patients. So, hemodialysis patients advice to examine the hematological parameters and treated from anemia if detected.
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Open Access October 30, 2022

Prevalence of Oral Health Problems and Distribution According to Socio-demographic Variables and Blood Groups among Patients in the Tripoli Region

Abstract Background: Oral health plays an important role in maintaining life functions and quality of life. Periodontal disease can vary with respect to bacterial etiology, host response, and clinical disease progression. A key role of genetic effects has suggested distribution of lesions and severity of destruction in each individual. Many diseases, particularly digestive disorders, cancer, and infection, show preferences among the ABO blood types. Knowledge of blood groups and their association with oral diseases is very important, as it may help in early diagnosis and treatment strategies‏. Objectives: The study aimed to investigate the distribution of patients with oral and dental health problems according to age, regions, Socio-demographic Variables, and blood groups in the Tripoli region. Material and Methods: The present study was conducted on 200 patients with oral and dental health problems attending six medical centers in Tripoli region from the 01st March 2022 to the 01st June 2022. Also, 100 healthy individuals without any oral and dental health problems or any other diseases were recruited as a control group. This study was approved by the Research and Ethical Committee of the medical centers and Libyan Academy of graduate studies. One ml of venous blood was withdrawn from each participant in the study for determination of blood groups. The data were compared using Chi-Square using SPSS Statistics for Windows, Version 25. Results: The results showed that the mean age of the patients was 43.03±13.82 years. The higher distribution of patients was 58 patients (29%) in the age group (26-35) years while the lower distribution was 10 patients (5%) in the age group (66-75) years. The distribution of patients according to the region were 81.5%, 13%, 4%, and 1.5% in Tripoli, South Tripoli, West Tripoli, and East Tripoli, respectively. The Distribution of patients according to occupation were 4.5% Students, 30% Housewives, 10.5% Employers, 12.5% Teachers, 14% Nurses, 7.5% Doctors, 12.5% Laboratory Technicians and 8.5% Freelance workers. The distribution of patients according to levels of education were 23.5% Pre-Secondary, 19% Secondary, 46% Bachelor's or equivalent, and 11.5% Master's or equivalent. The distribution of patients according to marital status were 26% single and 74% married. The distribution of patients according to oral and dental problems were 5% with bridge, 8% with missing teeth, 86% with dental caries, 63.5% with bleeding of gum, and 25.5% with swelling of gum. The degrees of gingival erythema among patients were 36.5% mild, 38% moderate, and 25.5% severe. The degrees of gingival inflammation among patients were 36% mild, 38.5% moderate, and 25.5% severe. The distribution of A, B, AB, and O blood groups showed a significant (P=0.000) difference between healthy individuals and oral and dental health problems among patients that, were 54%, 12%, 4%& 30%, and 21.5%, 9%, 3.5% & 66%, respectively. Also, the distribution of A+, A-, B+, B-, AB+, O+, and O- blood groups showed a significant (P=0.000) difference between healthy individuals and patients with oral and dental health problems that, were 49%, 5%, 10%, 2%, 4%, 25%, & 5%, and 18%, 3.5%, 8%, 1%, 3.5%, 60%& 6%, respectively. But, the distribution of Rh+ and Rh- blood groups showed a non-significant (P=0.695 [...] Read more.
Background: Oral health plays an important role in maintaining life functions and quality of life. Periodontal disease can vary with respect to bacterial etiology, host response, and clinical disease progression. A key role of genetic effects has suggested distribution of lesions and severity of destruction in each individual. Many diseases, particularly digestive disorders, cancer, and infection, show preferences among the ABO blood types. Knowledge of blood groups and their association with oral diseases is very important, as it may help in early diagnosis and treatment strategies‏. Objectives: The study aimed to investigate the distribution of patients with oral and dental health problems according to age, regions, Socio-demographic Variables, and blood groups in the Tripoli region. Material and Methods: The present study was conducted on 200 patients with oral and dental health problems attending six medical centers in Tripoli region from the 01st March 2022 to the 01st June 2022. Also, 100 healthy individuals without any oral and dental health problems or any other diseases were recruited as a control group. This study was approved by the Research and Ethical Committee of the medical centers and Libyan Academy of graduate studies. One ml of venous blood was withdrawn from each participant in the study for determination of blood groups. The data were compared using Chi-Square using SPSS Statistics for Windows, Version 25. Results: The results showed that the mean age of the patients was 43.03±13.82 years. The higher distribution of patients was 58 patients (29%) in the age group (26-35) years while the lower distribution was 10 patients (5%) in the age group (66-75) years. The distribution of patients according to the region were 81.5%, 13%, 4%, and 1.5% in Tripoli, South Tripoli, West Tripoli, and East Tripoli, respectively. The Distribution of patients according to occupation were 4.5% Students, 30% Housewives, 10.5% Employers, 12.5% Teachers, 14% Nurses, 7.5% Doctors, 12.5% Laboratory Technicians and 8.5% Freelance workers. The distribution of patients according to levels of education were 23.5% Pre-Secondary, 19% Secondary, 46% Bachelor's or equivalent, and 11.5% Master's or equivalent. The distribution of patients according to marital status were 26% single and 74% married. The distribution of patients according to oral and dental problems were 5% with bridge, 8% with missing teeth, 86% with dental caries, 63.5% with bleeding of gum, and 25.5% with swelling of gum. The degrees of gingival erythema among patients were 36.5% mild, 38% moderate, and 25.5% severe. The degrees of gingival inflammation among patients were 36% mild, 38.5% moderate, and 25.5% severe. The distribution of A, B, AB, and O blood groups showed a significant (P=0.000) difference between healthy individuals and oral and dental health problems among patients that, were 54%, 12%, 4%& 30%, and 21.5%, 9%, 3.5% & 66%, respectively. Also, the distribution of A+, A-, B+, B-, AB+, O+, and O- blood groups showed a significant (P=0.000) difference between healthy individuals and patients with oral and dental health problems that, were 49%, 5%, 10%, 2%, 4%, 25%, & 5%, and 18%, 3.5%, 8%, 1%, 3.5%, 60%& 6%, respectively. But, the distribution of Rh+ and Rh- blood groups showed a non-significant (P=0.695) difference between healthy individuals and patients that, were 88% & 12%, and 89.5%& 10.5%, respectively. Conclusion: It can be concluded that the mean age of the patients with oral and dental health problems was 43.03 years and the higher distribution of patients was in the age group (26-35) years. The higher distribution of ABO blood groups was O blood group among patients especially O+ blood groups. The distribution of Rh+ and Rh- blood groups were showed a non-significant difference between healthy individuals and patients with oral and dental health problems. Further studies are needed to confirm these results.
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