Retrospective Evaluation of Hematological Indicators in Predicting CKD Progression
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Background
The chronic kidney disease progression is affected by numerous factors, such as hematological abnormalities. Once reliable hematological prognostic factors are identified, early risk stratification and management of patients can be improved.
Objective
To retrospectively study whether hematological parameters are correlated with chronic kidney disease progression among patients at Kisii Teaching and Referral Hospital.
Methods
We reviewed records of 120 CKD patients who had baseline and follow-up data from April 2024 to April 2025. CKD stages were classified according to KDIGO 2012 guidelines. Progression was considered if there was a decline of at least one CKD stage or initiation of dialysis during follow-up. An array of hematological markers was studied: hemoglobin (Hb), hematocrit (Hct), red cell distribution width (RDW), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cells (WBC), neutrophils, lymphocytes, neutrophil-to-lymphocyte ratio (NLR), and platelets. Group comparisons were done using the t-test and ANOVA, and independent predictors were identified by multivariate logistic regression.
Results
Some 48.3% of patients progressed to CKD. With increased stages of CKD, Hb, Hct, and lymphocyte counts dropped significantly, while RDW and NLR increased significantly (p < 0.001). Progressors had significantly lower Hb, Hct, MCV, MCH, and lymphocyte counts but higher RDW and NLR than non-progressors (all with p < 0.05). The results of the logistic regression showed that lower Hb, higher RDW, higher NLR, and lower lymphocyte counts were independent predictors of progression (Hb: aOR=0.57, p<0.001; RDW: aOR=1.51, p=0.005); (NLR: aOR=1.89, p=0.002); (lymphocytes: aOR=0.46, p=0.048).
Conclusion
Hematological markers, mainly Hb, RDW, NLR, and lymphocyte count, remain important prognostic markers for CKD progression and may be incorporated into routine clinical monitoring with a view to intervening early.
