SAT-114 ASSESSMENT OF IRON STATUS IN PATIENTS WITH PRE-DIALYSIS CKD IN A TERTIARY HOSPITAL IN NORTH-CENTRAL NIGERIA

Abstract

Anaemia in CKD and is associated with poor quality of life and cardiovascular disease. Iron deficiency anaemia (IDA) contributes to the anaemia burden but studies on iron status in patients with pre-dialysis CKD in Northern Nigeria are sparse. The aim of the study is to determine iron status and its relationship with CRP in patients with CKD in a tertiary hospital in North-central Nigeria. We conducted a cross-sectional study on 130 patients with pre-dialysis CKD. We obtained the socio-demography, body mass index, waist and hip circumferences, history of hypertension and diabetes mellitus; and etiology of CKD. We assessed the complete blood count, serum ferritin, transferrin, iron, total iron binding capacity (TIBC), transferrin saturation (TSAT), highly sensitive C‑reactive protein, and serum creatinine. CKD-EPI was used to estimate glomerular filtration rate (eGFR). Normal iron status was defined as serum ferritin >100 ng/ml and TSAT >20; functional iron deficiency as serum ferritin >100 ng/ml and TSAT <20%; and absolute iron deficiency as serum ferritin <100 ng/ ml and TSAT <20%. The mean age of the study participants was 55 ± 15 years with a male to female ratio of 2.3: 1. The mean haemoglobin was 9.8±2.2g/dl and is worse as eGFR declines. IDA was present in 27.7% of the patients (17.7% had functional iron deficiency while 10% had absolute iron deficiency). There was no significant association between IDA and age, or gender. The median serum ferritin was 257.50 (102.75 – 465.00)ng/ml, serum transferrin 298.00 (216.00 – 343.25)mg/dl, serum iron was 21.85 (11.80 – 29.63) umol/l, TIBC 74.00 (54.00 – 84.65)umol/l, and TSAT of 32.55 (19.06 – 43.00)%. The median C-reactive protein (CRP) was 3.80 (1.60 – 4.10) mg/l, and correlated weakly with serum ferritin (r=0.177, p=0.044) and white blood cell count (r=0.199, p=0.024). Sixty percent of the patients had hs-CRP levels at high-risk (>3.0mg/L) for cardiovascular disease. Functional iron deficiency is the major contributor to iron deficiency anaemia in our patients with pre-dialysis CKD. Iron store is associated with CRP, which levels are at high-risk for cardiovascular disease in majority of patients. Initial assessment of iron status is recommended to inform early treatment.