Thesis

CHANDANA VISHWANATHAM

KAMINENI INSTITUTE OF MEDICAL SCIENCES,NARKETPALLY

Study on management of renal anemia in chronic kidney disease patients on maintainance hemodialysis in a rural medical hospital 

PROBLEM STATEMENT

Anaemia is almost an inevitable consequence of CRF. Nearly everyone with end-stage renal disease (ESRD) have anaemia.

Consequences of anaemia include decreased cognitive function, decreased exercise tolerance and a feeling of inadequate wellbeing as well as increased left ventricular hypertrophy that result in increased cardiovascular morbidity and mortality. Hence, anaemia is associated with increased morbidity and mortality in chronic renal failure patients, and early correction of anaemia will improve the outcomes in these patients.

Proper management of anaemia in patients with renal failure can lead to a reduction in left ventricular hypertrophy, enhanced quality of life, improved cognitive function, greater capacity to work or exercise and improved sexual function. 

Anemia is recognised as an extremely important factor in improving the outcomes of haemodialysis patients. Hence, this study on management of anaemia in haemodialysis patients is proposed by me. 

AIMS
1.To study prevalence of anemia in various stages of CKD on MHD.
2.To study the response of anemia in CKD on MHD to iv iron and erythropoietin and various factors affecting the response.

Inclusion criteria

1.CKD on MHD

2.age >18years

3.Hb <10mg/dl

4.patients of both sexes

Exclusion criteria
1.CKD not on MHD

2.age <18years

3.Hb>10mg/dl

STUDY DESIGN:

A prospective obeservational study in the ICU of Kamineni institute of medical sciences Narketpally Nalgonda Telangana.

PLACE OF STUDY : Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally.

STUDY PERIOD : October 2020-September 2022

STUDY DESIGN : Prospective Study

SAMPLE SIZE : Proposed No.of cases to be studied = 50

PROFORMA 

Name:

Age:

Sex:

Occupation:

Stage of CKD :

On MHD since:

Investigations for the assessment of renal function
Blood urea:
Serum creatinine:
Urine albumin:
Urine sugar:
USG abdomen:
eGFR using cockcroftgault formula:

Investigations for the assessment of haematological changes
Hb:

Hct:

MCV:
MCH:
MCHC
PBS findings:
Rectic count:
Serum albumin:
                     

Erythropoiesis parameters during the study period(1month)
Number of dialysis sessions 

IV iron consumption(mg/month):

ESA dose received per month:

PRBC transfusions

Well known predictors of ESA response

Hb post treatment :

S ferritin:
                
S albumin:
                  
S Iron