HEMATOLOGICAL AND BIOCHEMICAL ALTERATIONS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS WITH COEXISTING CHRONIC KIDNEY DISEASE

Abstract

Chronic Obstructive Pulmonary Disease (COPD) and Chronic Kidney Disease (CKD) are two progressive debilitating conditions with high global prevalence. Both disorders share common risk factors such as smoking, systemic inflammation, oxidative stress, and aging. The coexistence of COPD and CKD is increasingly recognized, with each condition potentially aggravating the other. Anemia, electrolyte disturbances, and metabolic derangements are frequently reported in these patients, yet the combined hematological and biochemical alterations remain underexplored. Understanding these abnormalities is crucial for improving clinical outcomes and tailoring management strategies.

Objective: To evaluate hematological and biochemical alterations in patients with COPD coexisting with CKD and to determine their clinical significance in disease severity and prognosis.

Methodology: This cross-sectional observational study was conducted at Hameed Latif Hospital over a period of 12 months from January to December 2024. A total of 150 patients were enrolled, including 75 patients diagnosed with COPD and CKD (study group) and 75 age- and sex-matched COPD patients without CKD (control group). Diagnosis of COPD was confirmed by spirometry, while CKD was staged using eGFR (KDIGO criteria). Hematological parameters included hemoglobin, hematocrit, red cell indices, white blood cell count, and platelet count. Biochemical parameters included serum creatinine, urea, electrolytes (Na⁺, K⁺, Ca²⁺, phosphate), and inflammatory markers (CRP). Data were analyzed using SPSS 25.0. Independent t-test and chi-square test were applied, with p < 0.05 considered statistically significant.

Results: The study group showed significantly lower mean hemoglobin levels (9.8 ± 1.6 g/dL vs. 12.1 ± 1.4 g/dL, p < 0.001) and higher prevalence of normocytic normochromic anemia compared to controls. Leukocytosis and elevated CRP were more frequent in COPD patients with CKD (p < 0.01). Biochemical analysis revealed significantly elevated serum creatinine (4.2 ± 1.8 mg/dL), urea (110 ± 28 mg/dL), hyperkalemia (p < 0.01), and hypocalcemia (p < 0.05) in the study group. The severity of hematological derangements correlated with advanced CKD stage and reduced FEV₁ in COPD (r = 0.42, p < 0.01).