Analysis of Red Blood Cell Parameters and Serum Iron Profile in Patients with Chronic Kidney Disease: A Retrospective Cross-sectional Study

Introduction: Chronic Kidney Disease (CKD) is a progressive loss of kidney function that frequently leads to anaemia, primarily due to erythropoietin deficiency. Anaemia in CKD exacerbates cardiovascular risk, reduces quality of life, and accelerates disease progression, particularly in advanced stages. Regular monitoring of Red Blood Cell (RBC) parameters is essential for accurate anaemia classification and management. Aim: To analyse RBC parameters and the serum iron profiles in patients at different stages of CKD and to determine their associations with renal function markers. Materials and Methods: The present retrospective crosssectional study was conducted at Yenepoya Medical College and Hospital, Mangalore, Karnataka, India. Data from 113 CKD patients aged ≥18 years, collected between May 2024 and May 2025, were analysed. Parameters assessed included RBC count, haemoglobin, haematocrit, Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), serum iron profile (serum iron, Total Iron-Binding Capacity [TIBC], and serum ferritin), peripheral smear findings, blood urea, and serum creatinine. The relationships between RBC parameters, iron profile parameters, serum creatinine, and blood urea were analysed using Pearson’s correlation coefficient. A p-value <0.05 was considered statistically significant. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 27. Results: Among the 113 patients, 79 (69.91%) were male, and 84 (74.34%) were in stage 5 CKD. Moderate anaemia was the most common severity, observed in 79 patients (69.91%). The severity of anaemia increased with advancing CKD stage. The mean haemoglobin level was 8.21 g/dL. Serum creatinine showed moderate, statistically significant negative correlations with RBC count, haemoglobin, and packed cell volume (r=-0.31 to -0.33, p<0.001). Blood urea also demonstrated moderate negative correlations with these parameters (r=-0.24 to -0.28, p <0.01). Serum iron exhibited a weak positive correlation with serum creatinine (r=0.26, p=0.006). Normocytic normochromic anaemia (91%) was the predominant peripheral smear pattern. Conclusion: Anaemia is a common and progressive complication of CKD, with severity increasing as renal function declines. Monitoring RBC parameters and iron profiles is essential for accurate anaemia classification, optimising treatment strategies, and preventing unnecessary iron supplementation, particularly in advanced stages of CKD.