MO789SERUM SOLUBLE TRANSFERRIN RECEPTOR IS A PROMISING MARKER OF IRON DEFICIENCY ANEMIA IN PREVALENT HEMODIALYSIS PATIENTS

Abstract

Abstract Background and Aims End stage renal disease (ESRD) is chronic inflammatory condition which affects iron parameters. Serum soluble transferrin receptor (sTfR) is a reliable indicator for assessing iron status in inflammatory conditions. This study evaluates the usefulness of serum sTfR in iron deficiency anemia detection in prevalent hemodialysis patients. Method This case-control study included 40 ESRD patients on conventional hemodialysis with CRP>10, 40 ESRD patients with CRP<10 and 8 apparently healthy controls. Serum sTfR was measured for all patients and controls. Results STFRs predicts iron deficiency anemia in prevalent hemodialysis patients at cut off value 12.5 mg/l with area under curve 0.949, sensitivity 88.75, specificity 100, PPV 100% and NPV 47.1%. The prevalence of STFRs in patients with CRP<10 was 85%, while in patients with CRP>10 was 92.5% (P-value 0.288). Patients who have elevated STFRs have risk 1.22 times to have iron deficiency anemia if CRP <10 (odds ratio: 1.22) and 3.14 times if CRP>10 (odds ratio: 3.14). There was significant difference on comparing patients with CRP<10, CRP>10 and control as regard haemoglobin and STFR with P-value 0.0001 and 0.0001 respectively. Post Hoc analysis showed significant difference between the patients with CRP<10 and control also in patients with CRP>10 and control as regard haemoglobin and STFR (p value <0.0001). on comparing patients with CRP<10 with patients with CRP>10 there was significant difference in STFRs p value 0.0001 despite no significant difference in haemoglobin (p value 0.642) and classic iron markers (s.iron, TIBC, TSAT) with p value 0.701, 0.192, 0.382 respectively. Serum STFRs was negatively correlated with s.iron and Kt\v in patients with CRP <10 (r -0.372, P-value 0.018) and (r-0.416, p value 0.008) respectively. Conclusion Serum soluble transferrin receptor is a highly sensitive and specific marker of iron deficiency anemia in hemodialysis patients especially with high CRP level.