Frequency of Folic Acid Deficiency in Chronic Kidney Disease Patients in a Tertiary Care Hospital of Bangladesh

Background: Chronic kidney disease (CKD) is a major global health burden, often leading to cardiovascular complications, end-stage renal disease, and reduced survival. Dietary potassium restriction in CKD patients limits folic acid intake, resulting in diminished serum folate levels. Additionally, metabolic alterations, systemic inflammation, and multiple comorbidities further contribute to folic acid and vitamin B12 deficiency. Gastrointestinal issues such as anorexia, gastroparesis, and altered gut microbiota also worsen the deficiency. This study aimed to determine the frequency of serum folic acid deficiency among CKD patients in a tertiary care hospital in Bangladesh. Objectives: To find out the frequency of serum folic acid deficiency in chronic kidney disease patients in a Tertiary Care Hospital of Bangladesh. Methods: This descriptive cross-sectional study was conducted in the Department of Medicine and Nephrology, Mymensingh Medical College Hospital, Mymensingh, over a six-month period from 19th April 2020 to 18th October 2020. A total of 96 patients with chronic kidney disease (CKD), stage 4 and stage 5, aged between 20 and 75 years, who attended the Department of Medicine and Nephrology and met the inclusion criteria, were enrolled using a purposive sampling technique. Clinical examination and relevant investigations were performed. Venous blood samples were collected from all patients to assess serum creatinine and serum electrolytes, which were analyzed using standard laboratory methods. Data were processed and analyzed using SPSS version 22, and a p-value of <0.05 was considered statistically significant. Result: In this study, the majority of patients 35.4% were aged 51–60 years, with a mean age of 58.15 ± 8.08 years. Out of 96 cases 61.45% were male and 38.5% female, showing higher CKD frequency with increasing age. The main etiologies were diabetes 46.8%, hypertension 38.5%, and chronic glomerulonephritis 12.5%. Overall, folic acid deficiency was present in 51.0% of patients. Its prevalence rose with disease stage, affecting 35.4% in Stage IV and 79.4% in Stage V CKD and progression of stage of CKD increased the folic acid deficiency. Conclusions: CKD often leads to complications such as folic acid deficiency, which becomes more prevalent in advanced stages and contributes to anemia and cardiovascular risk. Early detection and proper management of folic acid deficiency are essential to prevent further complications.