Comprehensive Haematological Alterations in Chronic Kidney Disease: Pathophysiological Mechanisms and Clinical Implications in Patients Attending Private Hospitals in Baghdad

ABSTRACT: Chronic Kidney Disease (CKD) is a worldwide health concern related to the gradual deterioration of kidney function with various complex systemic complications. Among these complications, haematological changes, including anaemia, are widespread and warrant analysis. This cross-sectional study aimed to assess haematological parameters, including red blood cell indices, white blood cell count, and platelet count, in the management of CKD. 300 patients suffering from CKD (stages 3-5) were observed in this study. Data on demographic, clinical, and laboratory parameters were obtained, such as complete hemograms, reticulocyte counts, iron status, inflammation markers, and coagulation evaluations. The results showed that a high percentage of normocytic, normochromic anaemia was correlated with CKD stages. Elevated ferritin and low transferrin levels accompanied functional iron deficiency. At the same time, the WBC count showed pronounced lymphopenia and a high neutrophil-to-lymphocyte ratio, indicating a chronic inflammatory condition. Platelet counts were generally normal, but mean platelet volume increased with the disease process, indicating mild platelet activation. Overall, the findings prove that haematological disorders have a multiple nature and are due to the lack of erythropoietin production, toxicity of uremia, and chronic inflammation. When it comes to private healthcare services in Baghdad, where people suffer from different conditions, socioeconomic features, and types of care, it can seem that patients do not receive proper treatment for observed haematological alterations. Keywords: Chronic Kidney Disease, Haematological Alterations, Anaemia, Neutrophil-to-Lymphocyte Ratio, Uremic Toxins, Baghdad.