EJMS

Abstract

Background: Malnutrition is associated with significant impairment of cell-mediated immunity, phagocyte function, complement system, secretory immunoglobulin and antibody concentrations, cytokine production and an altered immune response. Haemodiaysis leads to temporary removal of monocytes from the bloodstream followed by the reappearance of activated cells. Hepatitis C patients tend to have higher baseline hemoglobin. Methods: 25 patients at hemodialysis unit in Cairo Hospital (Cairo Medical Center, CMC), Heliopolis, Cairo, Egypt. Age ranged from 30 years to 80 years. 17 of them were males and the other 8 were females. Sera and fresh plasma from those patients were collected as follows: 10 HCV patients undergoing hemodialysis (group I); 10 HCV-negative hemodialysis patients (group II) and 5 HCV without renal failure patients (group III) as controls. Samples were exmained for complete blood count (CBC) by automated technique. Results: All patients in group I had mild Normocytic normochromic anaemia and Anisocytosis while 20% of them had lymphopenia, Monocytosis, Leucocytosis or shift to left. In groupII, 70% of patients had mild Normocytic normochromic anaemia and Anisocytosis, 50% had Monocytosis and Eosinophilia, 20% had Shift to left and 10% had Leucocytosis. In group III, 60% of patients had mild Normocytic normochromic anaemia, Anisocytosis and Thrombocytopenia and 20% had Shift to left. Conclusions: Anemia in hemodialysis patients is due to reduced erythropoietin production by the diseased kidneys. Thrombocytopenia is a common finding in chronic liver disease, complicating diagnostic and therapeutic invasive procedures and anti-HCV therapy in many patients. In hemodialysis patients infected by HCV, anemia can be managed by high doses of erythropoietin and discontinued Ribavirin treatment.