Relevant Hemolysis Parameter associated with ARF and CRF Patients in Dialysis

Relevant Hemolysis Parameter associated with ARF and CRF Patients in Dialysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Relevant Hemolysis Parameter associated with ARF and CRF Patients in Dialysis Hussein Dedy This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6405223/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Renal Failure (RF) patients undergoing hemodialysis and comparing them with studies period. This study aimed to determine the relevant hemolysis associated with Acute Renal Failure (ARF) and Chronic Renal Failure (CRF) patients in Centre of Dialysis and Renal Diseases in Hodiedah, Yemen. during the period years 2022. The study was designed in retrospective study ( cases series study) a set patient various stages of ARF and CRF who presented at the nephrology clinic and age and sex of patients of single value Concentrations of Creatinine, Hemoglobin (Hb), Mean Corpuscular Hemoglobin Concentration (MCHC), Hematocrit (HCT) and Hemolysis Parameters Use the Sysmex Hematological Analyzer for Assaying (CBC) and Spectrophotometers for Assaying Concentrations of Creatinine and Total Bilirubin. The study included 52 patients. The results showed That Relationships between the Observed Variables Relevant Hemolysis Parameter by Analyzer (CBC) association with Creatinine to ARF and CRF patients. The Mean of Age was 40 ± 20 years of patient with 75% of Males and 25% of Females. Mean Values of Serum Creatinine Significantly higher in the patients (8.15 ± 1.8 5 mg/dl). There was Significant Reduction in the Mean Values of Hb (7.55 ± 0.75 mg/dl ) and Values of HCT (25.3℅ ±2.5 ℅). The Mean Total Bilirubin was (13.95 ± 5.55 mg/dl) and Hemolysis (%) was (32.05 ± 12.65). and MCHC was 33.5 Stebal in these study. While the Mean of Age of ARF was 40 ± 20 years with 63.46% of Males, and 36.64% of Females. The Mean of Serum Creatinine Significantly higher in the patients (6.55 ± 4.15 mg/dl). There was significant lower in Hb Namely 8.95 ± 3.15 mg/dl and Values of HCT 29.9℅ ±10.5 ℅. The Mean of Total Bilirubin was 1.1 ± 0.9 mg/dl, Hemolysis 1.3 ℅ ± 0.88 ℅ and MCHC was 33.5 Stebal. ARF and CRF were higher Hemolysis Parameter that may result in either damage or lysis of the more fra gile populations of red blood cells (RBCs) because jaundice Disease and higher Creatinine, Blood Urea due to change in Osmolality in patients and filters Hemodialysis Devices play role . Hb MCHC HCT CBC Creatinine Total Bilirubin ARF CRF Hemolysis Hodeidah Yemen 1. INTRODUCTION Chronic Renal Failure (CRF) and Acute Renal Failure (ARF) are a major public health problem globally, and stages renal disease (SRD) is considered the most serious outcome of CRF[ 1 ]. Hemodialysis (HD) is one of the replacement therapy for chronic kidney disease; using HD involves the elimination of excessive toxic fluids and toxic metabolic end products from the body [ 2 ]. HD procedure is performed two to three times a week over two to four hours. The duration of dialysis varies according to many factors, including kidney function, amount of waste in the body, level of salts, as well as body weight [ 3 ]. The Complete Blood Count (CBC) is a test that evaluates the hemoglobin (Hb), Mean Corpuscular Hemoglobin Concentration (MCHC) and hematocrit (HCT) parameters. A CBC is typically performed using an automated instrument that measures various parameters. The results of a CBC can provide information about not only the number of cell types but also can give an indication of the physical characteristics of some of the cells [ 4 ]. Kidney failure affects different body organs, and among these effects: The effect on blood variables, as hemolysis parameter is one of the most important symptoms of kidney failure [ 5 ], it leads to a decrease in the Hb, HCT [ 6 , 7 ],and MCHC, creatinine is higher. 2. METHDOLOGY 2.1. Materials The materials of our study included solutions of hematological analyzer of Sysmex version 3 (Germany), reagent of hematological analyzer (Diluent CELLPACK), WBC/ RBC lyse reagent (STROMATOLOGYSER: The total bilirubin test required for plasma Hb were estimated using an spectrophotometer based on the manual biochemistry analyzer [ 8 , 9 ] . 2.2. Methods Retrospective data a set patient various stages of ARF and CRF who presented at the nephrology clinic and age and sex of patients of single value concentrations of creatinine, Hb, MCHC, HCT and hemolysis parameters based on the sysmex hematological analyzer for assaying the CBC and spectrophotometers for assaying concentrations of creatinine and total bilirubin to 52 patients with ARF and 4 patients with CRF were studied .. Hb, MCHC, HCT, creatinine and total bilirubin to detection the hemolysis parameter obtained from patients. The samples were collected in tube gell 5 ml of blood to assay of creatinine and total bilirubin, then centrifuged for 5 minutes at 2000 rpm while other samples were collected in tube EDTA. 2.5 ml of Blood to assay of Hb, MCHC and HCT parameters. On the other hand, the volumes were calculated by dividing the net weight of the red cell concentrates by their density. The data given to the results of the tests were analyzed using descriptive statistics and the normal distribution test (standard deviation) . 3. RESULTS The results showed that in the course of the relationships between the observed variables relevant hemolysis parameter by analyzer (CBC) association with creatinine and total bilirubin to CRF patients . The mean of age was 40 ± 20 years. 75 % of males, and 25% of females . The mean values of serum creatinine significantly higher in the patients ( 8.15± 1.8 5 mg/dl). There was significant lower in difference in the mean values of Hb (7.55 ± 0.75 mg/dl ) and values of HCT (25.3℅ ±2.5 ℅) . The mean total bilirubin was (13.95 ± 5.55 mg/dl) and hemolysis parameter (32.05 ℅ ± 12.65 ℅) and MCHC was 33.5 stebal in this study . While the ARF patients with mean of age (40 ± 20) years . 63.46% of males, and 36.64% of females. The mean values of serum creatinine significantly higher in the patients ( 6.55± 4.15 mg|dl). There was significant lower were in difference in the mean values of Hb (8.95 ± 3.15 mg/dl ) and values of HCT (29.9℅ ±10.5 ℅). The mean of total bilirubin was ( 1.1 ± 0.9 mg/dl) and hemolysis parameter ( 1.3 ℅ ± 0.88 ℅) and MCHC was 33.5 stebal in this study . Table (1): Characteristic laboratory of ARF and CRF Patients . Mean ± SD Characteristics ARF Patients CRF Patients Age ( 40 ± 20) years ( 40 ± 20) years Sex : Males Females 63.46 ℅ 36.64 ℅ 75 ℅ 25 ℅ Creatinine 6.55± 4.15 mg/dl 8.15± 1.8 5 mg/dl Hb 8.95 ± 3.15 mg/dl 7.55 ± 0.75 mg/dl MCHC 33.5 mg/dl 33.5 mg/dl HCT 29.9 ℅ ±10.5 ℅ 25.3℅ ±2.5 ℅ Total Bilirubin 1.1 ± 0.9 mg/dl 13.95 ± 5.55 mg/dl Hemolysis Parameter 1.3 ℅ ± 0.88 ℅ 32.05 ℅ ± 12.65 ℅ 4. DISCUSSION CRF has become a major public health problem ; that chronic diseases was the most common cause of CRF (71.53%) in Hodeidah , Yemen [10]. Previous study was carried in Hodeidah ,Yemen that reported ARF induced by cholera with case fatality rate (18.4 %) [11].The common risk factor were recorded for renal stones and salts patients were dehydration and nutrient that develop to renal failure in the future ]12[ .The finding of this study showed a significant decrease in Hb ,, HCT in patients with ARF and CRF who were subjected to HD, and these results were consistent with the results of These study of patients with ARF and CRF . The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-K / DOQI) determined the required Hb in patients with renal failure [13].Many studies have indicated that anemia is a common complication associated with CRF and CRF [14,15,17]. This is achieved through a decrease in HB concentration, , and HCT [10 ,16,18] . Results MCHC is plasma Hb stebal in plasma in ARF and CRF patients with the results of creatinine was higher in ARF and CRF patients. Results total bilirubin showed significant increase in CRF due to increase hemolysis parameter The highest hemolysis parameter because There are several common causes of hemolysis in acute renal failure (ARF) and chronic renal failure (CRF) patients undergoing dialysis: 1. Mechanical trauma: - Dialysis-related hemolysis can occur due to mechanical stress on red blood cells (RBCs) during the dialysis process, such as from pump action, turbulent blood flow, and interactions with the dialysis tubing and membrane. - This is known as mechanical or traumatic hemolysis. 2. Immune-mediated hemolysis: - ARF and CRF patients may develop autoimmune antibodies that target and destroy their own RBCs, leading to immune-mediated hemolytic anemia. - This can be exacerbated by the dialysis procedure and the exposure of the blood to foreign materials. 3. Oxidative stress: - The dialysis process can induce oxidative stress, which can damage RBC membranes and lead to hemolysis. - Factors contributing to oxidative stress include exposure to dialysis membranes, blood-air interface, and the presence of uremic toxins. 4. Electrolyte imbalances: - Disturbances in electrolyte levels, such as potassium or sodium, can alter the osmotic balance and integrity of RBCs, leading to hemolysis. - These imbalances can occur during the dialysis procedure or as a result of the underlying renal condition. 5. Vitamin and nutrient deficiencies: - Deficiencies in certain vitamins and nutrients, such as folic acid, vitamin B12, and iron, can impair RBC production and increase susceptibility to hemolysis. - These deficiencies are common in ARF and CRF patients due to dietary restrictions and increased nutrient requirements. 6. Underlying hematological disorders: - Some ARF and CRF patients may have pre-existing hematological conditions, such as sickle cell disease or paroxysmal nocturnal hemoglobinuria, that predispose them to increased hemolysis. Identifying and addressing the underlying causes of hemolysis in ARF and CRF patients undergoing dialysis is crucial for proper management and prevention of anemia and other complications. Absence studies priori in relevant hemolysis parameter associated with ARF and CRF Patients in Yemen.. 5. CONCLUSION ARF and CRF are higher hemolysis parameter that may result in either damage or lysis of the more fragile populations of RBCs because jaundice disease and higher creatinine , blood ueria due to change in osmolality in patients and the filters HD devices play role . The anemia of renal failure has been attributed to a relative hemolysis populations of RBCs in patients due to overall iron deficiency . Hb , MCHC , HCT parameters by (CBC) analyzer different stages of the concentrations of creatinine. Declarations 1. Ethical Approval: The title of the study explicitly states that it was conducted under the Research and Studies program at Al-Thawra General Hospital – Al-Hodeidah, indicating that the study was approved by the relevant authority. 2. Informed Consent: The study did not involve direct experiments on participants or data collection through interviews or surveys. Instead, it relied solely on data extracted from medical records. Therefore, obtaining informed consent from individuals was not required. 3. Research Interview: No research interviews were conducted since the study was based on analyzing previously recorded data. As a result, there is no supplementary document related to research interview questions. 4. Compliance with the Declaration of Helsinki: The study adhered to all ethical guidelines in accordance with the Declaration of Helsinki, ensuring data confidentiality and use strictly for research purposes. 5. Data Availability: A statement regarding data availability has been included in compliance with the journal’s policies. 6. Competing interests : The authors declare that they have no competing interests. 7. Funding : This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. 8. Acknowledgement : The authors would like to acknowledge the support of the National Blood Transfusion and Research Center and AL-Thawra Hospital, Hodeidah City, Yemen for providing valuable data and insights relevant to this study References Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012; 379:165-80. Raghunandan, S. Deepak Kumar, S. and Ram Lakhan, M. (2016). Effectiveness of Self Instructional Module (SIM) on knowledge regarding home care management among patients with chronic renal failure undergoing haemodialysis at selected hospital of Punjab. IOSR Journal of Nursing and Health Science, 5 (6): 20-31. Samaneka, W.P., Mandozana, G., Tinago, W., Nhando, N., Mgodi, N.M., BwakuraDangarembizi, M.F., Munjoma, M.W., Gomo, Z.A.R., Chirenje, Z.M. and Hakim, J.G. (2016). Adult Hematology and Clinical Chemistry Laboratory Reference Ranges in a Zimbabwean Population. PLOS One, 11 Al-Sheibani, S., Osman Taha, S., Balkam, F., Dhfash, A., & Amood Al-Kamarany, M. (2018). Validation Hematological Analyzer for Assay of Erythrogram in Hodeidah City, Yemen. Asian Hematology Research Journal, 1(1), 33–40. Retrieved from https://journalahrj.com/index.php/AHRJ/article/view/25 Habib, A., Ahmad, R. and Rehman, S. (2017). Hematological changes in patients of chronic renal failure and the effect of hemodialysis on these parameters. International Journal of Research in Medical Sciences, 5(11): 4998-5003. Momodu, I., Hamidatu, J.M., Makursidi, M.A. and Galadima, D.A. (2018). Effect of Haemodialysis on Some Haematological Parameters in Patients with End-Stage Renal Failure. Journal of Blood Research and Hematological Disease, 3:1. Muhammed, A., Zeb, M. A., Ullah, A., Afridi, I. Q. and Ali, A. (2020). Effect of haemodialysis on haematological parameters in chronic kidney failure patients Peshawar-Pakistan. Pure Applied Biology, 9(1): 1163-1169 . Operator Manual Automated Hematology Analyzer KX_ 21N Sysmex Corporation Kope Japan . 2003 . Operator Manual spectrophotometer Analyzer Kuber Human 2002 . Al Mutawakil, T. , Al Kamarany , M. A. ., Suhail, K. ., Kamal, A. ., & Alak, M. . (2024). Epidemiological Characteristics of Chronic Renal Failure Patients of Hodeidah, Yemen in 2023. Studies in Medical and Health Sciences, 1(1), 36–43. Retrieved from https://www.sabapub.com/index.php/SMHS/article/view/1151 Al Sheebani S, Al-Kamarany MA, Ghouth AB, Kamal A, Alaq M. (2018). Acute renal failure induced by cholera: outbreak of Hodeidah, Yemen, 2017. European Journal of Pharmaceutical and Medical Research. 5(8):188–192 Al-Kamarany, M., Al-Osimi, M., Majam, S. & Ogaili, M. 2016. Renal Stones among Adult of Hodeidah as Subtropical Region in Yemen: Prevalence, Risk Factors and Common Medication Used.British Biomedical Bulletin.4(2)412–417.http://www.imedpub.com/articles/renal-stones-amongadult-of-hodeidah-as-subtropicalregion-in-yemen-prevalence-risk-factors-and-commonmedicationused.pd The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-K / DOQI) Alghythan, A. and Alsaeed, A. H. (2012). Hematological changes before and after hemodialysis. Academic Journals, 7(4): 490-497. Dandekar , U.S. (2009). Association between Serum Ferritin and Body Composition in Young Women. University of Massachusetts, Amherst Magazine, 72. (6) Dandekar , U.S. (2009). Association between Serum Ferritin and Body Composition in Young Women. University of Massachusetts, Amherst Magazine, 72. (6) National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-K/ DOQI). (2000). Clinical practice guidelines for anemia of chronic kidney Disease. American Journal Kidney Diseases, 37: 5182- 238.(23) Yassein, R.B., Alseedig, N.O., Abd Allah, S.K., Mohmmed, A.A., Alballah5, N.A. and Syid, M.A. (2016). Haematological parameters among Sudanese patients with chronic kidney failure. International Journal of Research – Granthaalayah, 4(1): 50-54.(34) Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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INTRODUCTION","content":"\u003cp\u003eChronic Renal Failure (CRF) and Acute Renal Failure (ARF) are a major public health problem globally, and stages renal disease (SRD) is considered the most serious outcome of CRF[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Hemodialysis (HD) is one of the replacement therapy for chronic kidney disease; using HD involves the elimination of excessive toxic fluids and toxic metabolic end products from the body [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. HD procedure is performed two to three times a week over two to four hours. The duration of dialysis varies according to many factors, including kidney function, amount of waste in the body, level of salts, as well as body weight [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The Complete Blood Count (CBC) is a test that evaluates the hemoglobin (Hb), Mean Corpuscular Hemoglobin Concentration (MCHC) and hematocrit (HCT) parameters. A CBC is typically performed using an automated instrument that measures various parameters. The results of a CBC can provide information about not only the number of cell types but also can give an indication of the physical characteristics of some of the cells [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Kidney failure affects different body organs, and among these effects: The effect on blood variables, as hemolysis parameter is one of the most important symptoms of kidney failure [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], it leads to a decrease in the Hb, HCT [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e],and MCHC, creatinine is higher.\u003c/p\u003e"},{"header":"2. METHDOLOGY","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Materials\u003c/h2\u003e \u003cp\u003eThe materials of our study included solutions of hematological analyzer of Sysmex version 3 (Germany), reagent of hematological analyzer (Diluent CELLPACK), WBC/ RBC lyse reagent (STROMATOLOGYSER: The total bilirubin test required for plasma Hb were estimated using an spectrophotometer based on the manual biochemistry analyzer [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] .\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Methods\u003c/h2\u003e \u003cp\u003eRetrospective data a set patient various stages of ARF and CRF who presented at the nephrology clinic and age and sex of patients of single value concentrations of creatinine, Hb, MCHC, HCT and hemolysis parameters based on the sysmex hematological analyzer for assaying the CBC and spectrophotometers for assaying concentrations of creatinine and total bilirubin to 52 patients with ARF and 4 patients with CRF were studied .. Hb, MCHC, HCT, creatinine and total bilirubin to detection the hemolysis parameter obtained from patients. The samples were collected in tube gell 5 ml of blood to assay of creatinine and total bilirubin, then centrifuged for 5 minutes at 2000 rpm while other samples were collected in tube EDTA. 2.5 ml of Blood to assay of Hb, MCHC and HCT parameters. On the other hand, the volumes were calculated by dividing the net weight of the red cell concentrates by their density. The data given to the results of the tests were analyzed using descriptive statistics and the normal distribution test (standard deviation) .\u003c/p\u003e \u003c/div\u003e"},{"header":"3. RESULTS","content":"\u003cp\u003eThe results showed that in the course of the relationships between the observed variables relevant hemolysis parameter by \u0026nbsp;analyzer (CBC) association with creatinine and total bilirubin to CRF patients . The mean of age was 40 \u0026plusmn; 20 years. 75 % of males, and 25% of females . The mean values of serum creatinine significantly higher in the patients ( 8.15\u0026plusmn; 1.8 5 mg/dl). There was significant lower in difference in the mean values of Hb (7.55 \u0026plusmn; 0.75 mg/dl ) and values of HCT \u0026nbsp;(25.3℅ \u0026plusmn;2.5 ℅) . The mean total bilirubin was (13.95 \u0026plusmn; 5.55 mg/dl) and hemolysis parameter (32.05 ℅ \u0026plusmn; 12.65 ℅) and MCHC was 33.5 stebal in this study \u0026nbsp;. While the ARF patients with mean \u0026nbsp;of age (40 \u0026plusmn; 20) years . 63.46% of males, and 36.64% of females. The mean values of serum creatinine significantly higher in the patients ( 6.55\u0026plusmn; 4.15 mg|dl). There was significant lower were in difference in the mean values of Hb (8.95 \u0026plusmn; 3.15 mg/dl ) and values of HCT (29.9℅ \u0026plusmn;10.5 ℅). The mean of total bilirubin was ( 1.1 \u0026plusmn; 0.9 mg/dl) and hemolysis parameter ( 1.3 ℅ \u0026plusmn; 0.88 ℅) and MCHC was 33.5 stebal in this \u0026nbsp;study .\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (1): \u0026nbsp; Characteristic laboratory \u0026nbsp;of ARF and CRF \u0026nbsp;Patients .\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 507px;\"\u003e\n \u003cp\u003eMean\u0026nbsp;\u0026plusmn;\u0026nbsp;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eARF Patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eCRF Patients\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eAge\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e( 40 \u0026plusmn; 20) years\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e( 40 \u0026plusmn; 20) years\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eSex :\u003c/p\u003e\n \u003cul\u003e\n \u003cli\u003eMales\u003c/li\u003e\n \u003cli\u003eFemales\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e63.46 ℅\u003c/p\u003e\n \u003cp\u003e36.64 ℅\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e75 ℅\u003c/p\u003e\n \u003cp\u003e25 ℅\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eCreatinine\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e6.55\u0026plusmn; 4.15 mg/dl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e8.15\u0026plusmn; 1.8 5 mg/dl\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eHb\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e8.95 \u0026plusmn; 3.15 mg/dl\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e7.55 \u0026plusmn; 0.75 mg/dl\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMCHC\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e33.5 mg/dl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e33.5 mg/dl\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eHCT\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e29.9 ℅ \u0026plusmn;10.5 ℅\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e25.3℅ \u0026plusmn;2.5 ℅\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eTotal Bilirubin\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e1.1 \u0026plusmn; 0.9 mg/dl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e13.95 \u0026plusmn; 5.55 mg/dl\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003eHemolysis Parameter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e1.3 ℅ \u0026plusmn; 0.88 ℅\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e32.05 ℅ \u0026plusmn; 12.65 ℅\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"4. DISCUSSION","content":"\u003cp\u003eCRF has become a major public health problem ; that chronic diseases was the most common cause of CRF (71.53%) in Hodeidah , Yemen [10]. Previous study was carried in Hodeidah ,Yemen that reported ARF induced by cholera with case fatality rate (18.4 %) [11].The common risk factor were recorded for renal stones and salts patients were dehydration and nutrient that develop to renal failure in the future ]12[ .The finding \u0026nbsp;of this study showed a significant decrease in Hb ,, HCT in patients with ARF and CRF who were subjected to HD, and these results were consistent with the results of These study of patients with ARF and CRF . The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-K / DOQI) determined the required Hb in patients with renal failure [13].Many studies have indicated that anemia is a common complication associated with CRF and CRF [14,15,17]. This is achieved through a decrease in \u0026nbsp;HB concentration, , and HCT [10 ,16,18] . Results MCHC is plasma Hb stebal in plasma in ARF and CRF patients with \u0026nbsp;the results of creatinine was \u0026nbsp;higher in ARF and CRF patients. Results total bilirubin showed significant increase \u0026nbsp;in CRF due to increase hemolysis parameter \u0026nbsp;The highest hemolysis parameter \u0026nbsp;because There are several common causes of hemolysis in acute renal failure (ARF) and chronic renal failure (CRF) patients undergoing dialysis:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1. Mechanical trauma:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - Dialysis-related hemolysis can occur due to mechanical stress on red blood cells (RBCs) during the dialysis process, such as from pump action, turbulent blood flow, and interactions with the dialysis tubing and membrane.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - This is known as mechanical or traumatic hemolysis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e2. Immune-mediated hemolysis:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - ARF and CRF patients may develop autoimmune antibodies that target and destroy their own RBCs, leading to immune-mediated hemolytic anemia.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - This can be exacerbated by the dialysis procedure and the exposure of the blood to foreign materials.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e3. Oxidative stress:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - The dialysis process can induce oxidative stress, which can damage RBC membranes and lead to hemolysis.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - Factors contributing to oxidative stress include exposure to dialysis membranes, blood-air interface, and the presence of uremic toxins.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e4. Electrolyte imbalances:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - Disturbances in electrolyte levels, such as potassium or sodium, can alter the osmotic balance and integrity of RBCs, leading to hemolysis.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - These imbalances can occur during the dialysis procedure or as a result of the underlying renal condition.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e5. Vitamin and nutrient deficiencies:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - Deficiencies in certain vitamins and nutrients, such as folic acid, vitamin B12, and iron, can impair RBC production and increase susceptibility to hemolysis.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - These deficiencies are common in ARF and CRF patients due to dietary restrictions and increased nutrient requirements.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e6. Underlying hematological disorders:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; - Some ARF and CRF patients may have pre-existing hematological conditions, such as sickle cell disease or paroxysmal nocturnal hemoglobinuria, that predispose them to increased hemolysis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIdentifying and addressing the underlying causes of hemolysis in ARF and CRF patients undergoing dialysis is crucial for proper management and prevention of anemia and other complications. Absence studies priori in relevant hemolysis parameter associated with ARF and CRF Patients in Yemen..\u003c/p\u003e"},{"header":"5. CONCLUSION","content":"\u003cp\u003eARF and CRF are higher hemolysis parameter \u0026nbsp;that may result in either damage or lysis of the more fragile populations of RBCs because jaundice disease and higher creatinine , blood ueria due to change in osmolality in patients and \u0026nbsp;the filters HD devices play role . The anemia of renal failure has been attributed to a relative hemolysis populations of RBCs in patients due to overall iron deficiency .\u003c/p\u003e\n\u003cp\u003eHb , MCHC , HCT parameters by (CBC) analyzer different stages of the concentrations of creatinine. \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e1. Ethical Approval:\u003c/strong\u003e The title of the study explicitly states that it was conducted under the Research and Studies program at Al-Thawra General Hospital \u0026ndash; Al-Hodeidah, indicating that the study was approved by the relevant authority.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2. Informed Consent:\u003c/strong\u003e The study did not involve direct experiments on participants or data collection through interviews or surveys. Instead, it relied solely on data extracted from medical records. Therefore, obtaining informed consent from individuals was not required.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3. Research Interview: \u003c/strong\u003eNo research interviews were conducted since the study was based on analyzing previously recorded data. As a result, there is no supplementary document related to research interview questions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4. Compliance with the Declaration of Helsinki: \u003c/strong\u003eThe study adhered to all ethical guidelines in accordance with the Declaration of Helsinki, ensuring data confidentiality and use strictly for research purposes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5. Data Availability:\u003c/strong\u003e A statement regarding data availability has been included in compliance with the journal\u0026rsquo;s policies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e6. Competing interests :\u003c/strong\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7. Funding :\u003c/strong\u003e This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e8. Acknowledgement : \u003c/strong\u003eThe authors would like to acknowledge the support of the National Blood Transfusion and Research Center and AL-Thawra Hospital, Hodeidah City, Yemen for providing valuable data and insights relevant to this study\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLevey AS, Coresh J. Chronic kidney disease. Lancet. 2012; 379:165-80.\u003c/li\u003e\n\u003cli\u003eRaghunandan, S. Deepak Kumar, S. and Ram Lakhan, M. (2016). Effectiveness of Self Instructional Module (SIM) on knowledge regarding home care management among patients with chronic renal failure undergoing haemodialysis at selected hospital of Punjab. IOSR Journal of Nursing and Health Science, 5 (6): 20-31.\u003c/li\u003e\n\u003cli\u003eSamaneka, W.P., Mandozana, G., Tinago, W., Nhando, N., Mgodi, N.M., BwakuraDangarembizi, M.F., Munjoma, M.W., Gomo, Z.A.R., Chirenje, Z.M. and Hakim, J.G. (2016). Adult Hematology and Clinical Chemistry Laboratory Reference Ranges in a Zimbabwean Population. PLOS One, 11\u003c/li\u003e\n\u003cli\u003eAl-Sheibani, S., Osman Taha, S., Balkam, F., Dhfash, A., \u0026amp; Amood Al-Kamarany, M. (2018). Validation Hematological Analyzer for Assay of Erythrogram in Hodeidah City, Yemen. Asian Hematology Research Journal, 1(1), 33\u0026ndash;40. Retrieved from https://journalahrj.com/index.php/AHRJ/article/view/25\u003c/li\u003e\n\u003cli\u003eHabib, A., Ahmad, R. and Rehman, S. (2017). Hematological changes in patients of chronic renal failure and the effect of hemodialysis on these parameters. International Journal of Research in Medical Sciences, 5(11): 4998-5003.\u003c/li\u003e\n\u003cli\u003eMomodu, I., Hamidatu, J.M., Makursidi, M.A. and Galadima, D.A. (2018). Effect of Haemodialysis on Some Haematological Parameters in Patients with End-Stage Renal Failure. Journal of Blood Research and Hematological Disease, 3:1.\u003c/li\u003e\n\u003cli\u003eMuhammed, A., Zeb, M. A., Ullah, A., Afridi, I. Q. and Ali, A. (2020). Effect of haemodialysis on haematological parameters in chronic kidney failure patients Peshawar-Pakistan. Pure Applied Biology, 9(1): 1163-1169 .\u003c/li\u003e\n\u003cli\u003eOperator Manual Automated Hematology Analyzer KX_ 21N Sysmex Corporation Kope Japan . 2003 . \u003c/li\u003e\n\u003cli\u003eOperator Manual spectrophotometer Analyzer Kuber Human 2002 . \u003c/li\u003e\n\u003cli\u003eAl Mutawakil, T. , Al Kamarany , M. A. ., Suhail, K. ., Kamal, A. ., \u0026amp; Alak, M. . (2024). Epidemiological Characteristics of Chronic Renal Failure Patients of Hodeidah, Yemen in 2023. Studies in Medical and Health Sciences, 1(1), 36\u0026ndash;43. Retrieved from https://www.sabapub.com/index.php/SMHS/article/view/1151 \u003c/li\u003e\n\u003cli\u003eAl Sheebani S, Al-Kamarany MA, Ghouth AB, Kamal A, Alaq M. (2018). Acute renal failure induced by cholera: outbreak of Hodeidah, Yemen, 2017. European Journal of Pharmaceutical and Medical Research. 5(8):188\u0026ndash;192\u003c/li\u003e\n\u003cli\u003eAl-Kamarany, M., Al-Osimi, M., Majam, S. \u0026amp; Ogaili, M. 2016. Renal Stones among Adult of Hodeidah as Subtropical Region in Yemen: Prevalence, Risk Factors and Common Medication Used.British Biomedical Bulletin.4(2)412\u0026ndash;417.http://www.imedpub.com/articles/renal-stones-amongadult-of-hodeidah-as-subtropicalregion-in-yemen-prevalence-risk-factors-and-commonmedicationused.pd\u003c/li\u003e\n\u003cli\u003eThe National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-K / DOQI)\u003c/li\u003e\n\u003cli\u003eAlghythan, A. and Alsaeed, A. H. (2012). Hematological changes before and after hemodialysis. Academic Journals, 7(4): 490-497.\u003c/li\u003e\n\u003cli\u003eDandekar , U.S. (2009). Association between Serum Ferritin and Body Composition in Young Women. University of Massachusetts, Amherst Magazine, 72. (6)\u003c/li\u003e\n\u003cli\u003eDandekar , U.S. (2009). Association between Serum Ferritin and Body Composition in Young Women. University of Massachusetts, Amherst Magazine, 72. (6)\u003c/li\u003e\n\u003cli\u003eNational Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-K/ DOQI). (2000). Clinical practice guidelines for anemia of chronic kidney Disease. American Journal Kidney Diseases, 37: 5182- 238.(23)\u003c/li\u003e\n\u003cli\u003eYassein, R.B., Alseedig, N.O., Abd Allah, S.K., Mohmmed, A.A., Alballah5, N.A. and Syid, M.A. (2016). Haematological parameters among Sudanese patients with chronic kidney failure. International Journal of Research \u0026ndash; Granthaalayah, 4(1): 50-54.(34)\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Hb, MCHC, HCT, CBC, Creatinine, Total Bilirubin, ARF, CRF, Hemolysis, Hodeidah, Yemen","lastPublishedDoi":"10.21203/rs.3.rs-6405223/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6405223/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eRenal Failure (RF) patients undergoing hemodialysis and comparing them with studies period. This study aimed to determine the relevant hemolysis associated with Acute Renal Failure (ARF) and Chronic Renal Failure (CRF) patients in Centre of Dialysis and Renal Diseases in Hodiedah, Yemen. during the period years 2022. The study was designed in retrospective study ( cases series study) a set patient various stages of ARF and CRF who presented at the nephrology clinic and age and sex of patients of single value Concentrations of Creatinine, Hemoglobin (Hb), Mean Corpuscular Hemoglobin Concentration (MCHC), Hematocrit (HCT) and Hemolysis Parameters Use the Sysmex Hematological Analyzer for Assaying (CBC) and Spectrophotometers for Assaying Concentrations of Creatinine and Total Bilirubin. The study included 52 patients. The results showed That Relationships between the Observed Variables Relevant Hemolysis Parameter by Analyzer (CBC) association with Creatinine to ARF and CRF patients. The Mean of Age was 40\u0026thinsp;\u0026plusmn;\u0026thinsp;20 years of patient with 75% of Males and 25% of Females. Mean Values of Serum Creatinine Significantly higher in the patients (8.15\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8 5 mg/dl). There was Significant Reduction in the Mean Values of Hb (7.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.75 mg/dl ) and Values of HCT (25.3℅ \u0026plusmn;2.5 ℅). The Mean Total Bilirubin was (13.95\u0026thinsp;\u0026plusmn;\u0026thinsp;5.55 mg/dl) and Hemolysis (%) was (32.05\u0026thinsp;\u0026plusmn;\u0026thinsp;12.65). and MCHC was 33.5 Stebal in these study. While the Mean of Age of ARF was 40\u0026thinsp;\u0026plusmn;\u0026thinsp;20 years with 63.46% of Males, and 36.64% of Females. The Mean of Serum Creatinine Significantly higher in the patients (6.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.15 mg/dl). There was significant lower in Hb Namely 8.95\u0026thinsp;\u0026plusmn;\u0026thinsp;3.15 mg/dl and Values of HCT 29.9℅ \u0026plusmn;10.5 ℅. The Mean of Total Bilirubin was 1.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9 mg/dl, Hemolysis 1.3 ℅ \u0026plusmn; 0.88 ℅ and MCHC was 33.5 Stebal. ARF and CRF were higher Hemolysis Parameter that may result in either damage or lysis of the more fra gile populations of red blood cells (RBCs) because jaundice Disease and higher Creatinine, Blood Urea due to change in Osmolality in patients and filters Hemodialysis Devices play role .\u003c/p\u003e","manuscriptTitle":"Relevant Hemolysis Parameter associated with ARF and CRF Patients in Dialysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-14 08:22:58","doi":"10.21203/rs.3.rs-6405223/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"38926742-63b8-4397-b013-7c13d3582173","owner":[],"postedDate":"April 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-04-14T08:23:00+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-14 08:22:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6405223","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6405223","identity":"rs-6405223","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}