Chronic kidney disease (CKD) is a global health problem, with very high cost of care and greater burden particularly in developing countries like India. Material and Method: This prospective observational study of effects on hemoglobin and red cell indices in CKD before and after hemodialysis conducted on 150 CKD patients in SRM Medical College Hospital & Research Centre. Results: The most frequent morphologic features were normochromic-normocytic (78.7%), microcytic hypochromic (14.7%),

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... tic (3.3%) and dimorphic (3.3.%). Haemoglobin (Hb) levels and platelets counts are significantly reduced in post dialysis with a mean level of Hb 8.7 when compared to pre dialysis mean value of 7.78g/dL. There was a significant increase in MCV, with decrease in MCH and MCHC in the post dialysis values compared to pre dialysis. Conclusion: These hematological abnormalities expose CKD patients to higher risk of anemia-related complications. The present investigation might help clinicians to initiate precautions before and after dialysis procedures.