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Positive correlation of glomerular filtration rate with burr cells on peripheral blood smear examination in patients with chronic kidney disease
Sari A.P.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: Chronic kidney disease may lead to various complications, one of which is anemia. The main causes of anemia in chronic kidney disease are erythropoietin (EPO) deficiency, chronic inflammation, iron deficiency, decreased red blood cell life span, and the accumulation of uremic toxins which can cause changes in the color, size, and shape of erythrocytes. This study was conducted to determine whether there is a positive correlation between glomerular filtration rate and the presence of burr cells in subjects with chronic kidney disease.METHODS: This cross-sectional study on chronic kidney disease involves 90 chronic kidney disease subjects with anemia complications. The stage of chronic kidney disease was assessed based on the glomerular filtration rate, while the erythrocyte morphology was seen from the examination of the peripheral blood smear, with results based on the color, size and shape of the erythrocytes. The statistical analysis used Fisher’s Exact Test and chi square test; the results are significant if the P value is <0.05.RESULTS: Complications of anemia were found in stages 3-5 chronic kidney disease with the most erythrocyte morphology being normocytic normochromic (P=0.005). On the examination of the peripheral blood smear, burr cells were found, especially in stage 5 chronic kidney disease (P=0.040), which showed a positive correlation between glomerular filtration rate and burr cells. Among 72 CKD patients undergoing hemodialysis, burr cells were present in 53 of them. However, they statistically had a negative correlation with the presence of burr cells (P=0.053). In addition, a negative correlation was also found between the level of anemia and body mass index with the presence of burr cells (P>0.05).CONCLUSIONS: There is a positive correlation between glomerular filtration rate and the presence of burr cells on the examination of the peripheral blood smear.