Abstract
<p><strong>Objectives: </strong>Anemia is a frequent disorder in patients with end stage renal disease. Erythropoietin is advised in these patients; however, this therapy is not effective in patients who are iron deficient. So, diagnosis of iron deficiency which is traditionally based on ferritin and other iron parameters becomes difficult in these patients, as chronic kidney disease is a chronic inflammatory condition which affects these markers and masks the iron deficiency. In present study, we assessed the reliability of another indicator of body iron supply; serum transferrin receptor, in hemodialysis patients. It is not affected in case of inflammation unlike other markers of iron status.</p><p><strong>Patients and Methods:</strong><strong> </strong>Eighty Patients with end</p><p>stage renal disease, 20 to 60 years of age and both sexes were included. All cases were examined for complete blood count, serum iron, serum ferritin, serum total iron binding capacity, transferrin saturation and serum soluble transferrin receptor. Data was analysed by using independent sample <em>t</em> test and Pearson’ correlation. A <em>p </em>value of ≤ 0.05 was considered as significant.<strong></strong></p><p><strong>Results: </strong>The results of our research showed that mean values of serum soluble transferrin receptor and serum ferritin were 3.28 ± 0.83 µg/ml and 286.31 ± 165 ng/ml respectively which were significantly higher than the upper normal limit (<em>p </em>&lt; 0.001). Levels of sTfR were statistically different (<em>p </em>= 0.002) between iron replete group (SF &gt; 100 ng/ml) and iron deplete group (SF &lt; 100 ng/ml). Additionally, there was negative and significant correlation between sTfR and Hemoglobin.</p><p><strong>Conclusions: </strong>Levels of serum soluble transferrin receptor can be used as a reliable marker of iron defi-ciency in hemodialysis patients.</p>
Highlights
Chronic kidney disease (CKD) is the gradual, progressive deterioration of kidney function
The results of our research showed that mean values of serum soluble transferrin receptor and serum ferritin were 3.28 ± 0.83 μg/ml and 286.31 ± 165 ng/ml respectively which were significantly higher than the upper normal limit (p < 0.001)
There are many drawbacks of traditional laboratory biomarkers of iron status when used in CKD patients: CKD is a pro-inflammatory condition, and the biological variability of serum iron, transferrin saturation, and ferritin is known to be great because of the underlying inflammation by which, the clinical interpretation of their results is complicated and wrong picture of the body iron status is created.[3]
Summary
Chronic kidney disease (CKD) is the gradual, progressive deterioration of kidney function. Anemia is a well known complication of CKD, which may be due to insufficient erythropoietin or from iron deficiency as a result of inadequate absorption or mobilization. There should be proper balance between stimulating erythropoiesis and maintaining adequate iron levels for optimal red cell production in CKD patients. Erythropoietic stimulating agents (ESAs) mobilize iron stores to promote red cell production; low stores of iron or decreased iron availability are the main factors. SOLUBLE SERUM TRANSFERRIN RECEPTOR (STFR) LEVELS IN HEMODIALYSIS PATIENTS which resist the effect of ESAs. Iron management (iron status assessment and iron treatment), is crucial component for treating anemia associated with CKD.[1,2]. Bone marrow iron stores are often considered as the best indicator of iron status ( this is not generally accepted); bone marrow aspiration is invasive and not without risks e.g. infection or bleeding at the biopsy site.[1]
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