EXPLORING THE IMPACT OF ANEMIA AND CALCIUM IMBALANCE ON THE STAGES AND PROGRESSION OF CHRONIC KIDNEY DISEASE: A STUDY OF PATIENTS IN SOUTH PUNJAB, PAKISTAN

BACKGROUND: Chronic kidney disease (CKD) poses a significant global health challenge, especially in developing regions such as South Punjab, where its prevalence is alarmingly high. Anemia and hypocalcaemia are common complications of CKD, yet their relationship with the disease severity remains poorly understood in this region. Globally, glomerulonephritis is a major cause of CKD, with particularly high prevalence in Asian countries. For instance, CKD affects approximately 10.6% of individuals in Nepal and up to 23.3% in Pakistan. Clinically, CKD is characterized by either kidney damage or a glomerular filtration rate (GFR) below 60 ml/min/1.73 m² sustained for over three months. Without proper treatment, CKD can advance to end-stage renal disease (ESRD) as kidney function continues to decline. OBJECTIVE: This study aimed to explore the relationship between anemia and serum calcium levels with the severity and progression of chronic kidney disease (CKD) among patients in South Punjab. METHODOLOGY: A cross-sectional study was performed at the Multan Institute of Kidney Diseases hospital in South Punjab, comprising 1, 437 male and 890 female patients with chronic kidney disease. Hemoglobin and serum calcium levels were measured and analyzed in relation to CKD stages, as defined by glomerular filtration rate (GFR). CONCLUSION: The study revealed a significant inverse correlation between CKD severity and both hemoglobin and serum calcium levels. Patients with more advanced CKD stages exhibited greater anemia and hypocalcemia. These results indicate that hemoglobin and serum calcium levels could be useful biomarkers for CKD progression, which may aid in early detection and enhance management strategies in resource-limited settings. KEYWORDS: CKD, Anemia, CA, HB, RF, Severity, Expansion, GFR.