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. 2021 Oct 27;9(11):1452.
doi: 10.3390/healthcare9111452.

Bone Marrow Hypocellularity in Patients with End-Stage Kidney Disease

Chia-Chen Hsieh  1   2 , Ming-Jen Chan  1   2 , Yi-Jiun Su  3 , Jen-Fen Fu  2   4 , I-Kuan Wang  5   6 , Chao-Yu Chen  1   2 , Cheng-Hao Weng  1   2 , Wen-Hung Huang  1   2 , Ching-Wei Hsu  1   2 , Tzung-Hai Yen  1   2
Affiliations

Bone Marrow Hypocellularity in Patients with End-Stage Kidney Disease

Chia-Chen Hsieh et al. Healthcare (Basel). .

Abstract

Background: Anemia and pancytopenia are not uncommon in patients with chronic kidney disease (CKD). Nevertheless, there is insufficient literature analyzing bone marrow pathology in patients with CKD or end-stage kidney disease (ESKD) receiving dialysis.

Methods: This observational cohort study included 22 patients with ESKD and 23 patients with CKD that received bone marrow biopsy and aspiration at Chang Gung Memorial Hospital. Demographic, hematological, and biochemical data were collected at the time of bone marrow study for analysis.

Results: Bone marrow aspiration demonstrated that patients with ESKD had a lower percentage of blasts than patients with CKD (0.52 ± 0.84 versus 1.06 ± 0.78 %, p = 0.033). Bone marrow biopsy revealed that the overall incidence of hypocellular bone marrow was 55.6%. Furthermore, patients with ESKD had higher proportion of hypocellular bone marrow than patients with CKD (72.7% versus 39.1%, p = 0.023). In a multivariate logistic regression model, it was revealed that ESKD status (odds ratio 9.43, 95% confidence interval 1.66-53.63, p = 0.011) and megakaryocyte count within bone marrow (odds ratio 0.48, 95% confidence interval 0.29-0.79, p = 0.004) were significant predictors for bone marrow hypocellularity.

Conclusion: Bone marrow hypocellularity is common in patients with kidney dysfunction. Hypocellular marrow occurs more frequently in patients with ESKD than patients with CKD.

Keywords: biopsy; bone marrow; chronic kidney disease; end-stage kidney disease; hypocellularity.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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