Abdul Rahman Mahmoud F. Nahas
1* 
, Raghdaa Hamdan Al Zarzour
2, Asmaa Salama M. Abu Laila
3, Ahmed Mahmoud Tabash
4, Ayman Mustafa Abu Mustafa
5 , Faten Mohamad Allyan
6 , Abdrabbou Mohammed Elregeb
7 , Eyad Elabed Muadi Abou Teior
8, Abdulkareem Mohammed Al-Shami
9, Mohamed Hassan Elnaem
1 1 Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Pahang, Malaysia
2 Discipline of Pharmacology, School of Pharmaceutical Sciences, University Sains Malaysia; Penang, Malaysia
3 Department of Pharmacy, El-Najar Hospital, Gaza Strip, Palestine
4 Department of Laboratory Medicine, El-Najar Hospital, Gaza Strip, Palestine
5 Continuing Education Department, Palestine College of Nursing, Gaza Strip, Palestine
6 Department of Biomedical Science, College of Medical Science, Israa University, Gaza Strip, Palestine
7 Department of Laboratory Medicine, European Hospital, Gaza Strip, Palestine
8 Nephrology Department, El-Najar Hospital, Gaza Strip, Palestine
9 Department of Pharmacy Practice and Clinical Pharmacy, PICOMS International University College, Kula Lumpur, Malaysia
Abstract
Introduction: Patients with end-stage renal disease (ESRD) are predisposed to nutritional deficiencies, resulting in vitamin B12 deficiency with negative hematologic consequences.
Objective: This study aimed to investigate the impact of intramuscular B12 on renal anemia among ESRD patients receiving hemodialysis (HD) at El-Najar hospital, Gaza Strip.
Patients and Methods: A case-control study conducted, which included 110 healthy controls and 110 HD patients who received B12 on a daily, weekly, and monthly basis over two months. Sociodemographics and current diseases were reported. Serum levels of serum B12, white blood cell (WBC), red blood cell (RBC), hemoglobin (Hb), mean corpuscular volume (MCV), and platelet (PLT) were recorded before and after treatment. Data analysis was conducted using SPSS.
Results: Baseline serum B12 level was significantly lower in HD patients compared to controls (362.62 ± 166.40 versus 483.36 ± 115.07 ρg/mL, P<0.001), which significantly improved after vitamin B12 treatment (639.08 ± 362.99 ρg/mL, P<0.001). Additionally, mean WBCs, RBCs, Hb, and PLT levels were significantly increased after treatment (P<0.001). Serum B12 level was positively and significantly (P<0.001) correlated with levels of WBC (r = 0.45), RBC (r = 0.43), Hb (r = 0.39) and PLT (r = 0.51), and negatively correlated with MCV (r = -0.46, P<0.001).
Conclusion: Administration of vitamin B12 improves serum B12 levels in HD patients, which was associated with increased WBCs, RBCs, Hb, and PLT levels and decreased MCV levels. Treatment by vitamin B12 can improve HD patients’ renal anemia. Future studies with larger sample sizes and prolonged follow-up are advocated.
Implication for health policy/practice/research/medical education:
In 110 ESRD patients who were on hemodialysis, we reported a significantly lower serum B12 levels, compared to 110 healthy individuals. The administration of vitamin B12 significantly improves serum B12 levels in our patients. Additionally, mean WBCs, RBCs, Hb and PLT counts were significantly increased. As such, vitamin B12 administration can improve renal anemia in ESRD patients receiving hemodialysis. Future research with a larger sample size and extended follow-up is encouraged.
Please cite this paper as: Nahas ARMF, Al Zarzour RH, Abu Laila ASM, Tabash AM, Abu Mustafa AM, Allyan FM, Elregeb AM, Abou Teior EEM, Elnaem MH, Al-Shami AM. Effect of B12 supplementation on renal anemia among hemodialysis patients at El-Najar hospital, Gaza strip. J Renal Inj Prev. 2022; x(x): e32009. doi: 10.34172/jrip.2022.32009.