Soluble Transferrin Receptor and Soluble Transferrin Receptor/Log Ferritin Ratio are Correlated with Iron Status in Regular Hemodialysis Patients

BACKGROUND: Monitoring of iron status in chronic kidney disease patients is important, however inflammation may hinder its monitoring. Soluble transferrin receptor (sTfR) is an alternative parameter to overcome this issue, whereas ferritin play a part in the inflammation process. Hence, the correlation between the sTfR ratio and the sTfR/log ferritin ratio with conventional iron status parameters in regular hemodialysis patients is necessary to be evaluated.METHODS: A cross-sectional was conducted in the current study. As many as 5 mL of blood (2 mL for sTfR and 3 mL for serum iron and ferritin levels) was collected. sTfR level was the blood-soluble transferrin receptor level measured by the enzyme-linked immunosorbent assay (ELISA). The amount of ferritin and serum iron was determined using the immunochemiluminescent process. To evaluate the correlation, the Pearson correlation test was used.RESULTS: A total of 80 subjects was included in this study. The mean of hemoglobin was 10.25±1.66 g/dL, serum iron was 58.19±26.56 g/dL, and the median ferritin was 520.4 (49.9-3606) ng/mL. The sTfR was significantly associated only with serum iron levels with a correlation coefficient of r=-0.242; p=0.031. The sTfR/log ferritin was significantly associated with serum iron l evels (InSI)(r=-0.255, p=0.022); and transferrin saturation (r=-0.295; p=0.008).CONCLUSION: sTfR/log ferritin has a negative and significant correlation with serum iron levels and transferrin saturation, while sTfR negatively correlated with serum iron levels. sTfR and sTfR/log ferritin may be considered as an alternative iron marker in inflammation setting such as CKD.KEYWORDS: sTfR/log ferritin, iron status, serum iron, ferritin, chronic kidney disease, hemodialysis

Download Full-text

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

e-CliniC ◽

10.35790/ecl.1.1.2013.3293 ◽

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

Download Full-text

GAMBARAN STATUS BESI PADA PASIEN PENYAKIT GINJAL KRONIK YANG MENJALANI HEMODIALISIS

e-CliniC ◽

10.35790/ecl.2.2.2014.5049 ◽

2014 ◽

Vol 2 (2) ◽

Author(s):

Kurniawan K. Patambo ◽

Linda W. A. Rotty ◽

Stella Palar

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

World Health Organization ◽

Serum Iron ◽

Iron Status ◽

Transferrin Saturation ◽

World Health ◽

Primary Data ◽

Age Group ◽

Health Organization

Abstract: Chronic Kidney Disease (CKD) is a process of patofisiologis with multiple etiology, resulting in decline kidney function that is progressive and generally ending with kidney failure. The incidence of the patients with CKD in developing countries, is estimated to be around 40-60 cases per 1 million citiziens per year. The World Health Organization (WHO) estimated that there will be an increase in patients with kidney disease in Indonesia as much as 41.4% between 1995-2025. In Indonesia, from data in some parts of Nephrology, estimated incidence of CKD range 100-150 per 1 million citiziens. This research aims to know the description of iron status in Chronic Kidney Disease who undergoing Hemodialysis in Intalation of Hemodialysis was BLU Prof. Dr. R.D. Kandou Hospital. Method: This study uses descriptive retrospective method based on primary data from research period November 2013 - December 2013 in the Installation of Hemodialysis was BLU. Prof. Dr. R. D. Kandou Hospital. Research variables used are age, sex, the results of the laboratory test, the cause of CKD, undergoing long-term of Hemodialysis. Result: The results are from 57 total patient who included in research criterion there 41 (72%) men and 16 (28%) woman, based on the age group, group of age 41-64 38 (67%), the distribution of laboratory results based on hemoglobin levels in men at levels of 8-8.9 g/ dL, 15 (37%), as well as the women in the highest levels of hemoglobin levels of 8-8.9 g/ dL 5 (32%), based on hematocrit levels in men - most men in levels of 24-26.9% 14 (34%), and women most at levels of 21-23.9% 5 (32%), based on the highest value of serum iron value of 59-158 ug/ dL 33 (58%), based TIBC value most in the value <250 ug / dL 52 (91%), based on the highest value of transferrin saturation values >50% 27 (48%), based on the most cause of CKD due Nefrosclerosis Hypertension 56 (98%). Conclusion: On this research most on sex men and age group 20-64. Keywords: Chronic Kidney Disease, Iron serum, TIBC, Transferrin saturation. Abstrak: Penyakit ginjal kronik (PGK) merupakan suatu proses patofisiologis dengan etiologi yang beragam, mengakibatkan penurunan fungsi ginjal yang progresif dan pada umumnya berakhir dengan gagal ginjal. Insidens penderita PGK di negara-negara berkembang, diperkirakansekitar 40 - 60 kasus perjuta penduduk per tahun. World Health Organization (WHO) memperkirakan akan terjadi peningkatan pasien dengan penyakit ginjal di Indonesia sebesar 41,4% antara tahun 1995-2025. Di Indonesia, dari data di beberapa bagian nefrologi, diperkirakan insidens PGK berkisar 100-150 per 1 juta penduduk.Penelitian ini bertujuan untuk mengetahui gambaran status besi pada Penyakit Ginjal Kronik yang menjalani Hemodialisis di Instalasi Tindakan Hemodialisis BLU RSUP Prof. Dr. R.D. Metode: Penelitian ini menggunakan metode retrospektif deskriptif berdasarkan data primer pada periode November 2013 – Desember 2013 di Instalasi Tindakan Hemodialisis BLU RSUP. Prof. Dr. R. D. Kandou dengan variabel penelitian yang digunakan yaitu umur, jenis kelamin, hasil laboratorium, penyebab PGK, lama menjalani Hemodialisis. Hasil: Hasil dari peneltian ini adalah dari 57 pasien yang memenuhi kriteria inklusi berdasarkan jenis kelamin, laki – laki 41 (72%) dan perempuan 16 (28%), berdasarkan kelompok umur terbanyak pada usia 41-64 tahun 38 (67%), distribusi hasil laboratorium berdasarkan kadar hemoglobin, laki – laki terbanyak pada kadar 8-8,9 g/dL 15 (37%), sama halnya pada perempuan 5 (32%), berdasarkan kadar hematokrit pada laki – laki terbanyak pada kadar 24-26,9% 14 (34%), dan perempuan pada kadar 21 – 23,9% 5 (32%), berdasarkan nilai serum iron terbanyak nilai 59-158 ug/dL 33 (58%), berdasarkan nilai TIBC terbanyak nilai <250 ug/dL 52 (91%), berdasarkan nilai saturasi transferin ter-banyak nilai >50% 27 (48%), berdasarkan penyebab PGK terbanyak akibat Hipertensi nefrosklerosis 56 (98%). Simpulan:pada penelitian ini terbanyak pada jenis kelamin laki – laki dan kelompok umur 20 – 64 tahun. Kata kunci: Penyakit ginjal kronik, Serum iron, TIBC, Saturasi transferin.

Download Full-text

EFFICACY AND SAFETY OF IRON (III)–HYDROXIDE SUCROSE COMPLEX IN CORRECTION OF ANEMIA STAGE 5D CHRONIC KIDNEYDISEASE HEMODIALYSIS PATIENTS NOT TREATED BY ERYTHROPOIESIS–STIMULATING AGENTS (PROSPECTIVEANALYSIS)

Ukrainian Journal of Nephrology and Dialysis ◽

10.31450/ukrjnd.4(44).2014.07 ◽

2014 ◽

pp. 64-69

Author(s):

І. О. Dudar ◽

I. I. Gonchar ◽

І. М. Shifris ◽

Е. К. Krasjuk ◽

V. М. Savchuk ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Iron Deficiency ◽

Adverse Events ◽

Transferrin Saturation ◽

Hemodialysis Patients ◽

Renal Anemia ◽

Efficacy And Safety ◽

Dialysis Patients ◽

Regular Hemodialysis

The aim of study was to evaluat the efficacy and safety ofSUFER® (iron (III) sucrose complex) in correction of anemia stage 5D chronic kidney disease hemodialysis patients. Methods. This study included thirty patients undergoing regular hemodialysis (mean age 48,81±3,24 years, mean duration of dialysis 30,43±9,25 months) with renal anemia and iron deficiency. All patients were treated with SUFER® intravenously 200 mg three times a week. Correction dose was determined according to the manufacturer’s recommendations. Results. Mean level offerritin was significantly increased from 125,15 ± 21,46 ng / ml to 375,56 ± 64,12 ng / ml (p <0,001), transferrin saturation – from 17,48 ± 2,71% to 38,21 ± 4,90 ng / ml (p <0,001). 23 (76.67%) patients achieved target levels offerritin and transferrin, 12 (40% ) adverse events. Conclusions. SUFER® is effective and safety drug in dialysis patients.

Download Full-text

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

10.53350/pjmhs211582013 ◽

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.

Download Full-text

P0673INVERSE ASSOCIATION OF TRANSFERRIN SATURATION WITH MORTALITY RISK IN CHRONIC KIDNEY DISEASE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0673 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Xin Li ◽

Kristin Danielson ◽

Innas Forsal ◽

Ken Iseri ◽

Lu Dai ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Transplantation ◽

Kidney Disease ◽

Mortality Risk ◽

Iron Supplementation ◽

Iron Status ◽

Transferrin Saturation ◽

Resistance Index ◽

Competing Risk ◽

Dialysis Patients

Abstract Background and Aims Transferrin saturation (TSAT) is an indicator of iron deficiency or overload, but its relationship with mortality in patients with different stages of chronic kidney disease (CKD) is unclear. We investigated the association of TSAT with mortality in CKD patients. Method In 479 CKD patients (97 CKD3-4 patients, 298 CKD5 non-dialysis patients and 84 peritoneal dialysis patients; median age 58 years, 67% males, 33% cardiovascular disease, CVD, and 29% diabetes), biomarkers of iron status (plasma iron, TSAT, transferrin and ferritin), systemic inflammation (high sensitivity C-reactive protein, hsCRP, and interleukin-6, IL-6) and nutritional status were assessed. During median follow-up of 35.6 months, 139 (29%) patients died, and 176 (37%) patients underwent renal transplantation. Patients were stratified into low (n=157) and high (n=322) TSAT tertile groups. All-cause and CVD mortality risk were analyzed with competing risk regression with renal transplantation as competing risk. Results TSAT [median 23% (IQR 17-30%)] was negatively associated with presence of DM and CVD, body mass index, hsCRP, IL-6, Framingham´s CVD risk score (FRS), erythropoietin resistance index (ERI) and iron supplementation, and positively associated with hemoglobin, ferritin and s-albumin. In competing risk analysis, low tertile of TSAT was independently associated with increased all-cause mortality risk (sHR=1.50, 95%CI 1.05-2.14) after adjusting for CKD stages, 1-SD of FRS, 1-SD of hemoglobin, 1-SD of hsCRP, 1-SD of ESA dose and iron supplementation (Figure 1). Conclusion TSAT was inversely associated with mortality risk in CKD patients. When evaluating clinical outcomes of CKD patients, iron status using TSAT as a predictive marker, should be considered.

Download Full-text

Serum Soluble Transferrin Receptor in Heterozygous β-Thalassaemia: Application in the Diagnosis of Iron Deficiency and as Hematologic Marker of Erythroid Activity According to Thalassaemic Genotypes (β0 vs β+).

Blood ◽

10.1182/blood.v108.11.3828.3828 ◽

2006 ◽

Vol 108 (11) ◽

pp. 3828-3828

Author(s):

Jose Manuel Calvo-Villas ◽

María Francisca Zapata ◽

Ivan Alvarez ◽

Silvia de la Iglesia ◽

Jorge Cuesta ◽

...

Keyword(s):

Iron Deficiency ◽

Transferrin Receptor ◽

Biochemical Parameters ◽

Iron Status ◽

Direct Sequencing ◽

Saturation Index ◽

Transferrin Saturation ◽

Soluble Transferrin Receptor ◽

Iron Deficient ◽

Significant Difference

Abstract Although an increased level of serum soluble transferrin receptor (sTfR) have been found in both heterozygous β-thalassaemia patients with iron deficiency and in those with more severe genotype (β0), it is not a useful marker of iron deficiency status associated to β-thalassaemia. The aim of this study was to analyse the use of two biochemical parameters (sTfR and sTfR/log of ferritin ratio) to determine the iron status and to evaluate the degree of erythropoietic activity in a group of 221 β-thalassaemic heterozigotes patients (155 β0 and 66 β+). Serum ferritin and transferrin saturation index were measured in order to establish the iron status. Of the whole group, 51 patients were iron defficient (βthal-ID) while the remaining 170 were iron sufficient (βthal-IS). Based on the combination of β-thalassaemia genotype and iron status, patients were classified into four subgroups: β0thalassaemia and iron-sufficient (β0thal-IS) (n=124); β0thalassaemia and iron-deficient (β0thal-ID) (n=31); β+thalassaemia and iron-sufficient (β+thal-IS) (n=46); β+thalassaemia and iron-deficient (β+thal-ID) (n=20). 258 healthy and 56 iron-deficient individuals were used as controls. All the haematological parameters were measured by using analyzer Coulter® GEN-S™. Haemoglobins A2 (Hb A2) and F (HbF) were analysed by high performance liquid chromatography and molecular analysis was performed by real-time PCR and direct sequencing techniques. Chemical, inmunoturbidimetrical and nephelometric methods were used to measure iron status as well as sTfR. Comparison of haemalogical and biochemical parameters between subgroups was performed by using the t-student test and correlation analysis was calculated by using least-squares regression model. Mean sTfR level obtained was 2.63 ± 0.8 mg/dL and 2.57 ± 1.1 mg/dL in βthal-ID and βthal-IS patients respectively (p=0.783). Soluble transferrin receptor showed a positive correlation with HbA2, HbF and reticulocyte count values in βthal-IS patients (r=0.208 [p<0.05], r=0.440 [p<0.0001] and r=0.393 [p<0.00001] respectively) while it did not reach a significant correlation in βthal-ID patients. Mean sTfR/log sFt ratio was 2.75 ± 1.6 and 1.34 ± 0.5 in βthal-ID and βthal-IS patients (p<0.001). Interestingly, sTfR level was significantly higher in β0thal-IS patients when compared with β+thal-IS patients (2.76 ± 0.9 vs 1.42 ± 0.4) (p<0.001) as a result of an increased globin chains imbalance related to the β0 genotype. In the other hand, in the comparison between β0thal-ID and β+thal-ID subgroups neither sTfr level (2.71 ± 0.7 vs 2.40 ± 1.1) (p=0.417) nor sTfR/log sFt ratio (2.93 ± 1.7 vs 2.24 ± 1.3) (p=0.371) showed significant difference. In summary, sTfR/log sFt ratio is a valid parameter for diagnosis of iron deficiency associated to heterozygous β-thalassaemia. Unlike the findings observed in β-thalassaemic heterozigotes with normal iron status, sTfR level is not useful to evaluate the genotype severity in those with iron deficiency. Consequently, iron status should be determined before using sTfR as a parameter to provide a reliable estimation of the ineffective erythropoiesis related to the severity of β-thalassaemia genotypes.

Download Full-text

BODY IRON STATUS INDICATORS AND INFLAMMATION INDICATORS DURING INFLAMMATORY BOWEL DISEASE THERAPY IN CHILDREN AND ADOLESCENTES

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.202100000-09 ◽

2021 ◽

Vol 58 (1) ◽

pp. 48-54

Author(s):

Fernanda F CORRÊA ◽

Vera L SDEPANIAN

Keyword(s):

Children And Adolescents ◽

Interleukin 6 ◽

Transferrin Receptor ◽

Conventional Therapy ◽

Serum Iron ◽

Iron Status ◽

Infliximab Therapy ◽

Control Group ◽

Soluble Transferrin Receptor ◽

Body Iron

ABSTRACT BACKGROUND: The treatment of patients with inflammatory bowel disease (IBD) consists of the induction and maintenance remission of the disease. Iron status indicators would be useful for the diagnosis of iron deficiency anemia, whereas the inflammation indicators would be for the diagnosis of chronic disease anemia. OBJECTIVE: To assess body iron status indicators and inflammation indicators during the treatment of IBD, consisted of conventional or infliximab therapy in children and adolescents. METHODS: A case-control study of a sample of 116 individuals, of which 81 patients with IBD, 18 of them receiving conventional therapy, 20 infliximab therapy, and 43 who were in remission of the disease, and 35 healthy (control group) children and adolescents. Iron status and inflammation indicators were investigated at baseline, and 2 and 6 months of both therapies - conventional and infliximab. RESULTS: The mean age was 12.1±4.3 years. At baseline, both groups - conventional therapy and infliximab - presented significant differences in most markers studied compared to the control group. After 2 months of conventional therapy, hemoglobin and serum iron levels were lower than those of the control group; and red cells distribution width (RDW), total iron-binding capacity, transferrin receptor/ferritin ratio, and interleukin-6 were higher than the control group. After 2 months of infliximab treatment, hemoglobin and serum iron levels were lower than those of the control group; and RDW, soluble transferrin receptor, soluble transferrin receptor/ferritin ratio, and interleukin-6 were higher than the control group. After 6 months of conventional therapy, hemoglobin and serum iron levels were lower than those of the control group, and RDW and interleukin-6 were higher than those of the control group. After 6 months of infliximab treatment, the hemoglobin and serum iron levels were lower than the control group, and RDW, soluble transferrin receptor, soluble transferrin receptor/ferritin ratio, erythrocyte sedimentation rate, and platelets were higher than the control group. Regarding patients under treatment for at least one year (remission group), all markers studied, except transferrin, were similar to the control group. CONCLUSION: In conclusion, there were some contradictions among the different body iron status indicators and inflammation indicators at two and 6 months of treatment with conventional and infliximab therapy, however after one year of treatment, as shown by the remission group, all indicators studied, except transferrin, were similar to healthy children and adolescents.

Download Full-text

ANALYSIS OF RET-HE IN CHRONIC KIDNEY DISEASE PATIENTS AT DR.WAHIDIN SUDIROHUSODO HOSPITAL, MAKASSAR

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v25i1.1481 ◽

2019 ◽

Vol 25 (1) ◽

pp. 7

Author(s):

Febrina Rovani ◽

Asvin Nurulita ◽

Mansyur Arif

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Iron Homeostasis ◽

Complete Blood Count ◽

Binding Capacity ◽

Iron Status ◽

Transferrin Saturation ◽

Test Method ◽

Pathology Laboratory ◽

Significant Difference

Anemia, the common feature of Chronic Kidney Disease (CKD), is a multifactorial process due to disordered erythropoiesis and iron homeostasis. Determining the cause of anemia is important for adequate management. A bone marrow biopsy using Prussian Blue as the gold standard for diagnosis is invasive and more complicated to perform. Reticulocytes-Hemoglobin (Ret-He) a new parameter that indicates the hemoglobin content in reticulocytes is faster, easier, and less expensive. This study aimed to analyze the Ret-He in determining the iron status in patients with CKD. A cross-sectional study was held in the Clinical Pathology Laboratory of Dr. Wahidin Sudirohusodo Hospital Makassar during April-August 2016. Forty-five (45) samples were tested for iron serum (Fe), Total Iron Binding Capacity (TIBC), and Complete Blood Count (CBC) ordered by the physician. Reticulocytes-Hemoglobin was tested using the whole blood. Subjects were around the age of 19-71 years, no significant difference was found between numbers of males and females (46.6% and 53.3%). Hemoglobin median was 8 (5.0-15) g/dL, Fe 50 (6-177) U/mL, TIBC 183 (73-379), Transferrin Saturation (Tsat) 25 (5-95)%. Spearman correlation test method showed significant correlations between Ret-He and iron serum r=0.533, p <0.001, Ret-He and TIBC r=0.321 p=0.031 Ret-He and transferrin saturation r=0.416 p=0.019. The Mann-Whitney method showed no significant difference of Ret-He in both groups (Tsat <20% and >20%). There were significant correlations between Ret-He and iron, Ret-He and TIBC, Ret-He and transferrin saturation. A further study using larger samples is suggested to consider factors affecting the result of Ret-He.

Download Full-text

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

QJM ◽

10.1093/qjmed/hcab100.090 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Khaled Abou seif ◽

Hussien Sayed Hussien ◽

Shaimaa Abdelmegied ◽

Marwa Abdulhady

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Transferrin Receptor ◽

Iron Status ◽

Hemodialysis Patients ◽

Deficiency Anemia ◽

P Value ◽

Soluble Transferrin Receptor ◽

Significant Difference ◽

And Control

Abstract: Background Diagnosis of iron deficiency is traditionally based on ferritin and other iron parameters becomes difficult in end stage renal disease patients due to the inflammatory condition which affects these markers and masks the iron deficiency. Serum soluble transferrin receptor (sTfR) is able to be a reliable indicator for assessing iron status, as it is not affected by inflammatory procedures. Aim To evaluate the usefulness of serum soluble transferrin receptors in iron deficiency anemia detection in comparison to the classic markers of iron status in prevalent hemodialysis patients. Methods This case-control study assessed sTfR in 80 prevalent ESRD patients on regular hemodialysis in 2 groups. Group A (N = 40): CRP >10 and group B (N = 40):CRP <10 and apparently healthy 8 control subjects. Results The cut of value of STFRs in hemodialysis patients was 12.5 mg\l. The prevalence of STFRs in patients with CRP<10 was 85%, while in patients with CRP>10 was 92.5% (P-value 0.288). STFRs have high sensitivity 88.75, specificity 100, PPV100% and NPV 47.1%. The hemodialysis 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 Hb and STFR with P-value 0.0001 and 0.0001 respectively. Post Hoc analysis showed significant difference in both between the patients with CRP<10 and control also in patients with CRP>10 and control (p value <0.0001). while 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 hemoglobin (p value 0.642) and classic marker of iron deficiency (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 (r -0.372, P-value 0.018) and (r-0.416, p value 0.008) respectively in patients with CRP <10. Conclusion Serum soluble transferrin receptor is highly sensitive and specific marker for iron deficiency in hemodialysis patients especially in patients with high CRP level.

Download Full-text

Inverse association of transferrin saturation with mortality risk in chronic kidney disease

10.21203/rs.3.rs-20186/v1 ◽

2020 ◽

Author(s):

Xin Li ◽

Kristin Danielson ◽

Innas Forsal ◽

Ken Iseri ◽

Lu Dai ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Transplantation ◽

Kidney Disease ◽

Mortality Risk ◽

Iron Supplementation ◽

Iron Status ◽

Transferrin Saturation ◽

Competing Risk ◽

Dialysis Patients ◽

Cvd Mortality

Abstract Background: Transferrin saturation (TSAT) is an indicator of iron deficiency or overload, but its relationship with mortality in patients with different stages of chronic kidney disease (CKD) is unclear. We investigated the association of TSAT with mortality in CKD patients. Methods: In 479 CKD patients (97 CKD3-4 patients, 298 CKD5 non-dialysis patients and 84 peritoneal dialysis patients; median age 58 years, 67% males, 33% cardiovascular disease, CVD, and 29% diabetes), biomarkers of iron status (plasma iron, TSAT, transferrin and ferritin), systemic inflammation (high sensitivity C-reactive protein, hsCRP, and interleukin-6, IL-6) and nutritional status were assessed. During median follow-up of 35.6 months, 139 (29%) patients died, and 176 (37%) patients underwent renal transplantation. Patients were stratified into Low (n=157) and Middle and high (n=322) TSAT tertile groups. All-cause and CVD mortality risk were analyzed by competing risk regression with renal transplantation as competing risk. Results: TSAT (median 23%; interquartile range, 17-30%) was negatively associated with presence of diabetes and CVD, body mass index, hsCRP, IL-6, erythropoiesis stimulating agent (ESA) dose, erythropoietin resistance index (ERI) and iron supplementation, and positively associated with hemoglobin, ferritin and s-albumin. In competing risk analysis, low tertile of TSAT was independently associated with increased all-cause mortality risk (sHR=1.74, 95%CI 1.30-2.54) and CVD mortality risk (sHR=1.80, 95%CI 1.02-3.16) after fully adjusting for 1-standard deviation (SD) of age, sex, CKD stages, 1-SD of hemoglobin, 1-SD of ferritin, 1-SD of hsCRP, 1-SD of ESA dose and iron supplementation. Conclusions: Lower TSAT indicating iron deficiency was independently associated with increased mortality risk in CKD patients, underlining that iron status should be considered when evaluating clinical outcomes of CKD patients.

Download Full-text