scholarly journals A Study of Serum Iron Profile in Patients with Chronic Kidney Disease

2020 ◽  
Vol 7 (6) ◽  
pp. A253-257
Author(s):  
Indira Shastry ◽  
Sushma Belurkar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Iron Overload ◽  
Acute Phase ◽  
Serum Iron ◽  
Acute Phase Reaction ◽  
Phase Reaction ◽  
Anemia Of Chronic Disease ◽  
Iron Profile

Background: Even though anemia and iron deficiency can increase the morbidity and mortality in patients with chronic kidney disease (CKD), an iron overload can be dangerous as well. Aim: Identify the number of CKD patients with iron deficiency, iron overload, acute phase reaction and anemia of chronic disease in a tertiary care hospital. Material and methods: The study was conducted in Kasturba medical college, Manipal. 154 patients with CKD were selected for the study irrespective of their treatment status with hematinics and/or erythropoietin. Results: The mean total serum iron levels were 61μg/dl, Total Iron Binding Capacity (TIBC) 216.43 μg/dl, serum ferritin 539.68 μg/dl, and transferrin saturation of 32.18% respectively. When the serum iron profile of individuals was analyzed, majority (54.25%) of the patients were found to have acute phase reaction and most of them were in advanced stage of renal failure. Normal serum iron profile was found in 37.2% patients, iron overload in 2.2%, anemia of chronic disease in 5.3% and iron deficiency in 1% cases. These findings were statistically significant with the P value of 0.001. Conclusion: Most common type of serum iron profile found in the study population was acute phase reaction (54%) and majority of them were in stage 5 renal failure. Hence, before beginning an iron therapy, all the patients with anemia in chronic kidney disease should be evaluated for body iron status to prevent iron overload.

Correlation of Iron Profile with Different Stages of Chronic Kidney Disease in Children Presenting at a Tertiary Care Hospital

2021 ◽  
Vol 15 (8) ◽  
pp. 2013-2016
Author(s):  
Shahid Ishaq ◽  
Muhammad Imran ◽  
Hashim Raza ◽  
Khuram Rashid ◽  
Muhammad Imran Ashraf ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Overload ◽  
Serum Ferritin ◽  
Serum Iron ◽  
Tertiary Care ◽  
Transferrin Saturation ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Iron Profile

Aim: To determine correlation of iron profile in children with different stages of chronic kidney disease (CKD) presenting to tertiary care hospital. Methodology: A total of 81 children with chronic kidney disease stage having glomerular filtration rate (GFR) less than 90 (ml/min/m2) aged 1 – 14 years of either sex were included. Three ml serum sample was taken in vial by hospital duty doctor for serum ferritin level, serum iron, transferrin saturation and total iron binding capacity. The sample was sent to hospital laboratory for reporting. Iron profiling was done evaluating hemoglobin (g/dl), serum iron (ug/dl), serum ferritin (ng/ml), transferrin saturation (%) and total iron binding capacity (ug/dl) while iron load was defined as serum ferritin levels above 300 ng/ml. Correlation of iron profile with different stages of CKD was determined applying one-way analysis of variance (ANOVA). Results: In a total 81 children, 46 (56.8%) were boys while overall mean age was 7.79±2.30 years. Mean duration on hemodialysis was 11.52 ± 9.97 months. Iron overload was observed in 26 (32.1%) children. Significant association of age above 7 years (p=0.031) and residential status as rural (p=0.017) was noted with iron overload whereas iron overload was increasing with increase in stages of CKD (p=0.002). Hemoglobin levels decreased significantly with increase in stages of CKD (p<0.001). Serum iron levels increased significantly with increase in the CKD stages (p=0.039). Serum ferritin levels were increasing significantly with the increase in CKD stages (p=0.031). Transferrin saturation also increased significant with increase in CKD stages (p=0.027). Conclusion: High frequency of iron overload was noted in children with CKD on maintenance hemodialysis and there was linear relationship with stages of CKD and iron overload. Significant correlation of hemoglobin, serum iron, serum ferritin and transferrin saturation was observed with different stages of CKD. Keywords: Iron overload, maintenance hemodialysis, ferritin level.

scholarly journals Role of Serum Transferrin Receptor in Diagnosing and Differentiating Iron Deficiency Anemia from Anemia of Chronic Disease in Patients with Chronic Kidney Disease

2017 ◽  
Vol 7 (2) ◽  
pp. 132-137
Author(s):  
Abdul Latif ◽  
Muhammad Rafiqul Alam ◽  
Asia Khanam ◽  
Farhana Hoque ◽  
Muhammad Abdur Rahim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Chronic Disease ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Receptor ◽  
Deficiency Anemia ◽  
Control Group ◽  
Anemia Of Chronic Disease ◽  
Female Ratio

Background: Anemia is common in patients with chronic kidney disease (CKD) and this is generally anemia of chronic disease, but iron deficiency anemia (IDA) is also common. Soluble transferrin receptor (sTfR) is a useful marker for IDA. Present study was undertaken to assess the utility of sTfR as a marker of IDA in selected group of Bangladeshi patients with CKD.Methods: This cross-sectional study was conducted in the Department of Nephrology, BSMMU, Dhaka, Bangladesh from January 2013 to December 2014. Patients with anemia admitted in nephrology department whether on hemodialysis or not and medicine department of BSMMU were taken for study. The study population was further divided into two groups; Group A, patients who are having IDA and Group B, patients with ACD and a control group was also selected. Data were collected by face to face interview and laboratory investigations with a self-administered questionnaire.Results: The mean age of the patients in two study groups were 38.40±13.23 and 34.85±10.52 years respectively and male-female ratio were 0.5:1 and 1:0.5. Mean sTfR level was higher (4.81± 1.64 ?g/ml) in patients with IDA than (2.89±1.40 ?g/ml) in patients with ACD (p <0.0001). In our study mean ferritin level was 599.59± 449.15?g/L in ACD patients whereas 101.23±119.42 in IDA patients (p<0.0001). Total iron binding capacity (TIBC) was more in ACD patients with sTfRe”3?g/ml as compared to ACD patients with sTfR<3?g/ml. Transferrin saturation (TSAT) level was significantly decreased in ACD patients with sTfR ?3?g/ml as compared to ACD patients with sTfR<3?g/ml.Conclusion: sTfR has a comparable ability to S. ferritin in diagnosing IDA and ACD. However, sTfR and serum ferritin alone cannot definitely exclude co-existing iron deficiency in ACD. As sTfR is not affected by infection and/or inflammation, thus providing a non-invasive alternative to bone marrow study.Birdem Med J 2017; 7(2): 132-137

scholarly journals STATUS BESI PADA PASIEN PENYAKIT GINJAL KRONIK YANG SEDANG MENJALANI HEMODIALISIS DI BLU RSU.Prof.Dr.R.D KANDOU MANADO

e-CliniC ◽  
2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Cynthia Ombuh
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Medical Records ◽  
Serum Iron ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Blood Transfusions ◽  
Erythropoietin Deficiency ◽  
Epo Deficiency

ABSTRACTBackground: Chronic Kidney Disease (CKD) is kidney damage that occurred during the three months or more with a glomerular filtration rate less than 60 ml/men./1, 73 m2. One complication that often occurs in patients with CKD is anemia. Anemia in CKD can be caused by several factors such as EPO deficiency, Iron Deficiency, etc. and one of the parameters commonly examined in patients with CKD who are undergoing hemodialysis is composed of iron status Serum Iron(SI), TIBC, Transferrin Saturation, Ferritin.Objective: Looking iron status in CKD patientsMethods: The study design was a descriptive look at the medical records of the patients who are undergoing hemodialysis with purposive sampling technique.Results: In patients with CKD undergoing hemodialysis anemia. Anemia all experienced that often caused by the presence of erythropoietin deficiency. But there are also caused by iron deficiency from a status marked where the iron transferrin saturation <20%. There was also found an increase in ferritin> 400 ng / ml caused by the presence of an infection such as anemia or chronic disease can also be caused due to frequent blood transfusions. Treatment for iron overload in patients with CKD, especially regular hemodialysis patients who undergo repeated blood transfusions can be re-utilization by the use of ESA, anemia in CKD caused by deficiency erythropoietin.ESA therapy may also be given.Conclusion: Based on the results of research in the department of hemodialysis room Prof.Dr.RD Kandou obtained all patients with chronic kidney disease decreased hemoglobin, and Serum Iron which fell by 40%, the normal 60%, and ferritin were increased by 46.7% , that no data 53.3% and TIBC were decreased by 80%, as much as 20% of normal and Transferrin Saturation fell by 6.7%, which increased by 3.3% and as much as 90% of normal.Keywords: CKD, iron statusABSTRAKLatar Belakang : Penyakit Ginjal Kronik (PGK) adalah kerusakan ginjal yang terjadi selama atau lebih tiga bulan dengan laju filtrasi glomerulus kurang dari 60 ml/men./1,73 m2. Salah satu komplikasi yang sering terjadi pada pasien PGK adalah anemia. Anemia pada PGK dapat disebabkan oleh beberapa faktor seperti: Defisiensi EPO, Defisiensi Besi, dll dan salah satu parameter yang biasa diperiksa pada pasien PGK yang sedang menjalani hemodialisis adalah status besi yang terdiri dari Serum Iron (SI), TIBC, Saturasi Transferin, Feritin.Tujuan : Melihat Status besi pada pasien PGKMetode : Desain penelitian adalah deskriptif dengan melihat data rekam medik para pasien yang sedang menjalani hemodialisis dengan teknik purposive sampling.Hasil : Pada pasien PGK yang menjalani hemodialisis semuanya mengalami anemia.Anemia yang sering terjadi disebabkan oleh karena adanya defisiensi eritropoetin. Namun ada juga yang disebabkan oleh defisiensi besi yang ditandai dari pemeriksaan status besi dimana saturasi transferin < 20%. Ada juga didapatkan peningkatan Feritin > 400 ng/ml yang disebabkan oleh karena adanya infeksi seperti pada anemia penyakit kronis atau juga bisa disebabkan karena seringnya transfusi darah. Penatalaksanaan untuk kelebihan zat besi pada pasien PGK terutama pasien hemodialisis reguler yang mengalami transfusi darah berulang dapat dire-utilisasi dengan pemakaian ESA, anemia pada PGK yang disebabkan oleh dekfisiensi eritopoetin juga dapat diberikan terapi ESA.Kesimpulan : Berdasarkan hasil penelitian di ruangan hemodialisis di RSUP Prof.Dr.R.D Kandou didapatkan semua pasien penyakit ginjal kronik mengalami penurunan Hb,dan Serum Iron yang menurun sebanyak 40%, yang normal sebanyak 60%, dan Feritin yang meningkat sebanyak 46,7%, yang tidak ada data sebanyak 53,3% dan TIBC yang menurun sebanyak 80%, yang normal sebanyak 20% dan Saturasi Transferin yang menurun sebanyak 6,7% yang meningkat sebanyak 3,3% dan yang normal sebanyak 90%.Kata Kunci: PGK, Status Besi

scholarly journals Serum Soluble Transferrin Receptor-Ferritin Indices in Diagnosing and Differentiating Iron Deficiency Anemia from Anemia of Chronic Disease among Patients with Chronic Kidney Disease

2019 ◽  
Vol 9 (2) ◽  
pp. 151-156
Author(s):  
Abdul Latif ◽  
Farhana Hoque ◽  
Muhammad Rafiqul Alam ◽  
Asia Khanam ◽  
Sarwar Iqbal ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Chronic Disease ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Transferrin Receptor ◽  
Deficiency Anemia ◽  
Soluble Transferrin Receptor ◽  
Anemia Of Chronic Disease ◽  
Group A ◽  
Group B

Background: Anemia is common in patients with chronic kidney disease (CKD) and this is generally anemia of chronic disease (ACD), but iron deficiency anemia (IDA) is also common. Soluble transferrin receptor (sTfR) is a useful marker for IDA. Present study was undertaken to assess the utility of sTfR as a marker of IDA and to differentiate ACD from IDA in selected group of Bangladeshi patients with CKD. Methods: This cross-sectional study was conducted in the Department of Nephrology, BSMMU, Dhaka, Bangladesh from January 2013 to December 2014. Patients with anemia admitted in Nephrology Department, whether on hemodialysis or not and Medicine Department of BSMMU were taken for study. The study population was further divided into two groups; Group A, patients (30) who were having IDA and Group B, patients (40) with ACD and a control group was also selected. Data were collected by face to face interview and laboratory investigations with a self-administered questionnaire. Results: The mean age of the patients in Group A and Group B were 38.40±13.23 and 34.85±10.52 years respectively and male-female ratio were 0.5:1 and 1:0.5. Mean sTfR level was higher (4.81± 1.64 μg/ml) in patients with IDA than (2.89±1.40 μg/ml) in patients with ACD (p <0.0001). Mean ferritin level was 599.59± 449.15μg/L in ACD patients whereas 101.23±119.42 in IDA patients (p<0.0001). Total iron binding capacity (TIBC) was more in ACD patients with sTfRe”3μg/ml as compared to ACD patients with sTfR<3μg/ml. Transferrin saturation (TSAT) level was significantly decreased in ACD patients with sTfRe”3μg/ml as compared to ACD patients with sTfR<3μg/ml. sTfR and ferritin indices between group A (IDA) and group B (ACD) shows mean sTfR:logSF level was significantly (P<0.001) high in group A (2.71±1.13) in comparison to group B (1.08±0.54). Mean log sTFR:SF was also significantly higher (P<0.05) in group A (0.001±0.0008) compared to group B (0.013±0.012). Conclusion: sTfR level has a comparable ability to serum ferritin in diagnosing IDA and ACD. However, sTfR and serum ferritin alone cannot definitely exclude coexisting iron deficiency in ACD. Log sTfR/ ferritin index has role in identifying development of iron deficiency in ACD whereas sTfR/ log SF ratio can differentiate pure IDA from ACD with or without iron deficiency. Thus, it is important to estimate both serum sTfR and sTfRferritin indices to be able to differentiate pure IDA, ACD and ACD with co-existing iron deficiency thus providing a non-invasive alternative to bone marrow iron. Birdem Med J 2019; 9(2): 151-156

scholarly journals Evaluation of Iron Status by Bone Marrow Iron Stain and its Correlation with Serum Iron Profile in Chronic Kidney Disease (CKD)

1970 ◽  
Vol 25 (3) ◽  
pp. 117-120 ◽  
Author(s):  
Md Mahbubur Rahman ◽  
Pradip Kumar Dutta ◽  
Mahmudul Hoque ◽  
Md Iftikher Hossain Han ◽  
Dhiman Banik ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Bone Marrow ◽  
Kidney Disease ◽  
Serum Ferritin ◽  
Serum Iron ◽  
Iron Status ◽  
Tissue Iron ◽  
Bone Marrow Iron ◽  
The Mean ◽  
Iron Profile

This observational study was done on 52 cases of predialysis chronic kidney disease (CKD) patients with chronic anaemia. The aim of the study was to determine the tissue iron status, comparison of the tissue iron with serum iron profile and justification of giving iron in chronic kidney disease (CKD) patients on the basis of serum iron profile. Bone marrow iron stain was done in each case and compared with the serum iron profile. The mean age of the patients was 46.8 ± 12.6 years and the mean haemoglobin and serum creatinine levels of the study population were 9.36 ± 2.13 gm/dl and 8.0 ± 4.2 mg/dl respectively. Stainable iron deposits were present in 40 (77%) cases. The mean serum ferritin and transferin saturation (TSAT) of the 52 cases were found to be 412.9 ng/ml and 28.3% and that for the 12 iron deficient cases were 101.8 ng/ml and 23.8%. Over all normal (>100ng/ml <500ng/ml), increased (>500ng/ml) or low (>100 ng/ml) serum ferritin was found in 28 and 15 and nine cases respectively. On the other hand, normal (>20% >50%) and low (>20%) TSAT were found in 31 and 12 cases, and high TSAT (>50%) in only nine cases. Out of the 12 cases having no evidence of stainable iron in the marrow low serum ferritin and low TSAT were found in eight (66.6%) and six (50%) cases, and high TSAT and either normal or high serum ferritin in six (50%) & four (33.3%) cases respectively. Low TSAT was also found in six (15%) cases of those having iron deposits in the marrow. It is, therefore, concluded that absence of stainable iron in the bone marrow is a better evidence of iron depletion than the serum iron profile and that serum ferritin and TSAT correlate less well with the bone marrow iron status in patient with chronic kidney disease. (J Bangladesh Coll Phys Surg 2007; 25 : 117-120)

Iron Deficiency in the Acute-Phase Reaction After Open Aortic Surgery

2006 ◽  
Vol 40 (5) ◽  
pp. 392-398 ◽  
Author(s):  
J. V. Solis ◽  
J. L. Portero ◽  
J. Diaz ◽  
R. Garcia ◽  
J. M. Ligero ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Acute Phase ◽  
Aortic Surgery ◽  
Acute Phase Reaction ◽  
Phase Reaction

scholarly journals GAMBARAN ANEMIA DEFISIENSI BESI PADA PASIEN PENYAKIT GINJAL KRONIK STADIUM V YANG MENJALANI HEMODIALISIS DI INSTALASI TINDAKAN HEMODIALISIS RSUP PROF. DR. R.D. KANDOU MANADO

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Felix E. Suyatno ◽  
Linda W. A. Rotty ◽  
Emma S. Moeis
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Renal Disease ◽  
Iron Deficiency Anemia ◽  
End Stage Renal Disease ◽  
Serum Iron ◽  
Deficiency Anemia ◽  
Stage Renal Disease ◽  
End Stage

Abstract: Chronic kidney disease (CKD) is a pathophysiological process with varied etiology, results in progressive decrease of renal function, and generally ends up with renal failure. Data from Indonesian Association of Nephrology (PERNEFRI) in 2012 showed that 83% of all patients who underwent hemodialysis were with end-stage renal disease (ESRD) which is the terminal stage of CKD. In patients with CKD, there can be a wide variety of complications; one of them is anemia. This study aimed to obtain the overview of iron deficiency anemia of stage V CKD patients who were treated with hemodialysis in hemodialysis center of Prof. Dr. R. D. Kandou Central General Hospital Manado. This was a descriptive study with a cross sectional approach conducted from October to December 2015 in Prof. Dr. R. D. Kandou Hospital. Variables were age, sex, laboratory result, duration of hemodialysis, and the diagnosis of iron deficiency anemia. The results showed that there were 39 samples; females were 21 patients (53.8%). The largest age group was >60 years with 16 patients (41%). The degree of anemia mostly found was the moderate degree with 26 patients (66.7%). Five patients (12.8%) were diagnosed with iron deficiency anemia. Conclusion: In this study, the most common degree of anemia was moderate, followed by severe and slight anemia consecutively. Iron deficiency anemia cases were 12.8%. Keywords: chronic kidney disease, iron deficiency anemia, serum iron, transferrin saturation  Abstrak: Penyakit ginjal kronik (PGK) adalah suatu proses patofisiologik dengan etiologi beragam, mengakibatkan penurunan fungsi ginjal yang progresif, dan umumnya berakhir dengan gagal ginjal. Data dari Perkumpulan Nefrologi Indonesia (PERNEFRI) tahun 2012 menyatakan bahwa 83% dari seluruh pasien yang menjalani hemodialisis ialah pasien end stage renal disease (ESRD) yang merupakan stadium terminal PGK. Pada pasien PGK, dapat terjadi berbagai macam komplikasi, salah satunya ialah anemia Penelitian ini bertujuan untuk mengetahui gambaran anemia defisiensi besi pada pasien PGK stadium V yang menjalani hemodialisis di Instalasi Tindakan Hemodialisis RSUP Prof. Dr. R.D. Kandou Manado. Penelitian ini menggunakan metode deskriptif dengan pendekatan potong lintang berdasarkan data primer pada Bulan Oktober – Desember 2015. Variabel penelitian yang digunakan yaitu umur, jenis kelamin, hasil laboratorium, lama menjalani hemodialisis, dan diagnosis anemia defisiensi besi. Hasil penelitian memperlihatkan 39 sampel dengan distribusi sampel terbanyak ialah perempuan sebanyak 21 orang (53,8%), golongan umur terbanyak > 60 tahun sebanyak 16 orang (41%), derajat anemia terbanyak ditemukan ialah anemia derajat sedang sebanyak 26 orang (66,7%), dan terdapat 5 orang (12,8%) yang terdiagnosis anemia defisiensi besi. Simpulan: Pada penelitian ini ditemukan anemia derajat sedang yang terseing, diikuti anemia derajat berat dan ringan. Terdapat 12,8% pasien dengan anemia defisiensi besi. Kata kunci: penyakit ginjal kronik, anemia defisiensi besi, serum iron, saturasi transferin

scholarly journals Impact of Inflammation on Ferritin, Hepcidin and the Management of Iron Deficiency Anemia in Chronic Kidney Disease

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1173 ◽  
Author(s):  
Norishi Ueda ◽  
Kazuya Takasawa
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Iron Overload ◽  
Iron Deficiency Anemia ◽  
Iron Status ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Upper Limit ◽  
The Impact

Iron deficiency anemia (IDA) is a major problem in chronic kidney disease (CKD), causing increased mortality. Ferritin stores iron, representing iron status. Hepcidin binds to ferroportin, thereby inhibiting iron absorption/efflux. Inflammation in CKD increases ferritin and hepcidin independent of iron status, which reduce iron availability. While intravenous iron therapy (IIT) is superior to oral iron therapy (OIT) in CKD patients with inflammation, OIT is as effective as IIT in those without. Inflammation reduces predictive values of ferritin and hepcidin for iron status and responsiveness to iron therapy. Upper limit of ferritin to predict iron overload is higher in CKD patients with inflammation than in those without. However, magnetic resonance imaging studies show lower cutoff levels of serum ferritin to predict iron overload in dialysis patients with apparent inflammation than upper limit of ferritin proposed by international guidelines. Compared to CKD patients with inflammation, optimal ferritin levels for IDA are lower in those without, requiring reduced iron dose and leading to decreased mortality. The management of IDA should differ between CKD patients with and without inflammation and include minimization of inflammation. Further studies are needed to determine the impact of inflammation on ferritin, hepcidin and therapeutic strategy for IDA in CKD.

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