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)

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 P0861THE RELATIONSHIP BETWEEN HEPCIDIN-25 AND BONE MARROW IRON IN ANEMIC, NON-DIALYSIS, CHRONIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Cristina-Stela Capusa ◽  
Ana-Maria Mehedinti ◽  
Gabriela-Adriana Talimba ◽  
Ana Stanciu ◽  
Liliana Viasu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Bone Marrow ◽  
Kidney Disease ◽  
Linear Regression ◽  
Iron Content ◽  
Blood Smear ◽  
Transferrin Saturation ◽  
Peripheral Blood Smear ◽  
Iron Stores ◽  
Bone Marrow Iron

Abstract Background and Aims Hepcidin-25 (Hep25) is a key known regulator of iron metabolism and its interactions with inflammation, iron stores and erythropoietic activity were involved in the pathogenesis of chronic kidney disease (CKD)-associated anemia. Therefore, our aim was to assess the determinants of serum Hep25 level in non-dialysis CKD patients. Method In this cross-sectional, single-center study, 52 subjects (56% men, 65±13 years) with CKD [estimated glomerular filtration rate, eGFR 14.5 (95%CI 16 to 25) mL/min] and anemia [hemoglobin, Hb 9.8 (95%CI 9.2 to 9.9) g/dL], not treated with erythropoiesis-stimulating agents (ESA) or iron in the previous 6 months, were enrolled. Patients with anemia of other causes than CKD, active infectious and inflammatory diseases, malignancy, severe hyperparathyroidism, transfusions during the last 3 months, and immunosuppressive therapy were excluded. The iron status was evaluated using both peripheral and central parameters. The iron stores were assessed by serum ferritin (Fer) and iron content in bone marrow macrophages (iMf, measured quantitively on a scale from 0 to 6). The iron available for erythropoiesis was assessed by transferrin saturation (TSAT) and the percentage of sideroblasts (%Sb). Anemia was further evaluated by a peripheral blood smear, erythrocytes indices and reticulocyte index. Serum Hep25 and erythropoietin (Epo) were assessed by ELISA (Bachem®, and Abcam® 119522, respectively). C-reactive protein (CRP), albumin, and parameters of kidney disease (eGFR, proteinuria) were also measured. Mann-Whitney, Kruskal-Wallis, Chi2 tests, Spearman bivariate correlation and multiple linear regression were used for statistical analysis. Results The median serum Hep25 of the whole cohort was 82.1 (95%CI 68.7 to 92.1) ng/mL. According to median Hep25, subjects were clustered in Group 1 (below median - G1) and Group 2 (above median - G2). %Sb and reticulocyte index had higher levels in G2 than in G1 [9 (95%CI 5 to 14) vs. 5 (95%CI 4 to 7) %, p=0.003 and 0.55 (95%CI 0.39 to 0.77) vs. 0.41 (95%CI 0.32 to 0.58), p=0.05, respectively], while the proportions of subjects with iMf suggestive for iron deficiency or iron overload were similar in G2 and G1 (38% vs. 50%, p=0.40, and 26% vs. 23%, p= 0.75, respectively). Peripheral blood smear, peripheral iron indices and all the other studied parameters were also alike. In bivariate analysis, Hep25 was positively associated both with indices of iron stores, i.e. Fer (rs = 0.30, p=0.03) and iMf (rs = 0.34, p=0.01) and indices of iron available for erythropoiesis, i.e. %Sb (rs = 0.55, p&lt;0.001) and (marginally) with TSAT (rs = 0.26, p=0.06). Meanwhile, Hep25 was not related to serum Epo, CKD parameters or inflammation markers. In a multivariate linear regression model that explained 28% of Hep25 variation, the percentage of bone marrow sideroblasts, i.e. the tissue iron available for erythropoiesis, was the only independent determinant of Hep25: Variables entered in the first step: reticulocyte index, percentage of medullary sideroblasts (%Sb), iron content in the bone marrow macrophages (iMf), serum ferritin, and transferrin saturation Conclusion In stable patients with advanced CKD, not treated with ESA or iron, with low to moderate inflammation, serum hepcidin was related only to bone marrow iron available for erythropoiesis, suggesting that in this clinical setting the need of iron for erythropoiesis prevails over inflammation in regulation of hepcidin synthesis.

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.

Immunoradiometric serum ferritin concentration compared with stainable bone-marrow iron as indices to iron stores.

1980 ◽  
Vol 26 (1) ◽  
pp. 145-147 ◽  
Author(s):  
D T Forman ◽  
M V Vye
Keyword(s):  
Bone Marrow ◽  
Serum Ferritin ◽  
Binding Capacity ◽  
Iron Status ◽  
Clinical Value ◽  
Ferritin Concentration ◽  
Iron Stores ◽  
Specificity And Sensitivity ◽  
Bone Marrow Iron ◽  
Iron Binding Capacity

Abstract Immunoradiometric analysis has made it possible to measure ferritin reliably in serum. The determination is a sensitive means of assessing body iron because concentrations of ferritin closely parallel the body's reticuloendothelial iron stores. The information provided is similar to that obtained from bone-marrow aspirates or biopsies stained for iron with Prussian Blue. Comparative studies indicate good correlation between iron content in the marrow and serum ferritin, except possibly in patients with leukemia and metastatic tumors to the bone marrow. The clinical value of the assay in relation to other indicators of iron status (i.e., hemoglobin, erythrocyte indices, serum iron and iron-binding capacity, and erythrocyte protoporphyrin) is in its specificity and sensitivity for assaying physiological iron stores.

scholarly journals Correlation between Hemoglobin Reticulocytes and Ferritin in Chronic Kidney Disease Patients Undergoing Hemodialysis at PKU Bantul

2021 ◽  
Vol 17 (2) ◽  
pp. 133
Author(s):  
Muhammad Salman Shalahuddin ◽  
Linda Rosita
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Ferritin ◽  
Iron Status ◽  
Pearson Correlation ◽  
Univariate Analysis ◽  
Secondary Data ◽  
Cardiovascular Complications ◽  
Bivariate Analysis ◽  
Cross Sectional

Abstract: As many as 7 – 12% of the world's population has chronic kidney disease (CKD). CKD patients can experience various complications, one of which is anemia. Anemia can cause a variety of cardiovascular complications in CKD patients. Enforcement of the diagnosis of anemia and its type is carried out by laboratory examination, among others by examination of reticulocytes-hemoglobin (ret-he) and iron status such as serum ferritin. Examination of these parameters can help in planning the right treatment for CKD patients who have anemia. The purpose of this study was to determine the relationship of Ret-he with ferritin levels in CKD patients undergoing hemodialysis at PKU Bantul Hospital. This study used cross-sectional method. The data source used was secondary data obtained from medical records and the Indonesian Renal Registry (IRR). Sampling research used consecutive sampling method. The analysis used univariate analysis which was frequency distribution table, and bivariate analysis. Univariate analysis obtained that average levels of ret-he from 50 subjects was 28.87 ± 3.75 pg and median serum ferritin levels were 118,1 (9,76 – 1615) mL. Bivariate analysis with pearson correlation test found a significant correlation between serum ret-he and ferritin levels (r = 0.498, p = 0.000).There was a significant correlation between he-ret levels and serum ferritin levels Keywords: chronic kidney disease, anemia, reticulocytes-hemoglobin, serum ferritin.

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

2021 ◽  
Vol 13 (2) ◽  
pp. 201-7
Author(s):  
Yenny Kandarini ◽  
Gede Wira Mahadita ◽  
Sianny Herawati ◽  
Anak Agung Wiradewi Lestari ◽  
Ketut Suega ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Transferrin Receptor ◽  
Serum Iron ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Hemodialysis Patients ◽  
Enzyme Linked Immunosorbent Assay ◽  
Soluble Transferrin Receptor ◽  
Regular Hemodialysis

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

MO560IS SERUM ERYTHROPOIETIN CORRELATED WITH IRON METABOLISM AND INFLAMMATION IN NON-DIALYSIS CHRONIC KIDNEY DISEASE PATIENTS WITH ANEMIA?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Cristina-Stela Capusa ◽  
Ana-Maria Mehedinti ◽  
Ana Stanciu ◽  
Gabriela-Adriana Talimba ◽  
Liliana Viasu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Bone Marrow ◽  
Kidney Disease ◽  
Serum Albumin ◽  
Serum Ferritin ◽  
Iron Metabolism ◽  
Mean Corpuscular Hemoglobin ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Serum Hepcidin

Abstract Background and Aims Both the relative erythropoietin (Epo) deficiency and its relationship with serum hemoglobin (Hb) are widely postulated in chronic kidney disease (CKD), but the influence of chronic inflammation and iron status on serum Epo levels is still a matter of debate, with yet divergent reported results. Therefore, we aimed to assess the determinants of serum Epo in non-dialysis CKD patients. Method Fifty-two adults with CKD and anemia (defined as Hb &lt;12g/dL), in stable clinical condition, never treated with erythropoiesis-stimulating agents (ESA) entered this cross-sectional, single-center study. Diabetes mellitus, active infectious and inflammatory diseases, malignancy, anemia of other causes than CKD, current immunosuppressive therapy, iron supplementation and blood transfusions in the previous six months were exclusion criteria. The subjects were mostly men (56%), elderly (two thirds over 60 years), with advanced CKD [71% in CKD stages G4-G5, median estimated glomerular filtration rate – eGFR 14.5 (95%CI 16 to 25) mL/min], moderate anemia [Hb 9.8 (95%CI 9.2 to 9.9) g/dL], and mild to moderate inflammation [C-reactive protein 6 (95%CI 9.2 to 18.4) mg/L]. Serum Epo was assessed by ELISA (Abcam® 119522). Complete blood count, reticulocyte index, peripheral blood smear, bone marrow aspiration (Perls’ stain), serum ferritin, and transferrin saturation, were used to investigate anemia and iron metabolism. Parameters of kidney disease (CKD etiology, eGFR and proteinuria), demographic data (age, gender), C-reactive protein, serum albumin, and serum hepcidin-25 (Hep-25, Bachem® commercial ELISA kit) were also analyzed. Results The median serum Epo of the whole cohort was 4.8 (95%CI 5.1 to 9.9) mU/mL. According to median Epo, subjects were clustered in Group 1 (below median, G1) and Group 2 (above median, G2). Estimated GFR and serum Hep-25 were lower in G1 than in G2 [10.6 (95%CI 9.7 to 20.8) vs. 26 (95%CI 19.1 to 32.8) mL/min, p=0.004, and 62.6 (95%CI 51.0 to 85.1) vs. 95.4 (95%CI 77.0 to 108.5) ng/mL, p=0.03, respectively]. All the other investigated parameters were similar in the two groups. In bivariate analysis (Spearman rank correlation), serum Epo was positively associated only with eGFR (rs=0.40, p=0.003). Marginal associations with the percentage of bone marrow sideroblasts, as marker of the iron available for erythropoiesis (rs=0.25, p=0.08), erythrocyte mean corpuscular hemoglobin concentration (rs=−0.26, p=0.07), and reticulocyte index (rs=0.24, p=0.09) were observed. Conversely, serum Epo was not related to hemoglobin, indices of iron stores (e.g. serum ferritin and iron content in bone marrow macrophages), inflammation and nutritional status (e.g. C-reactive protein and serum albumin). In a model of multiple linear regression which explained 14% of serum Epo variation, eGFR was the only determinant: Beta 0.14 (95%CI 0.05 to 0.23), p=0.004. Also, a binary logistic multiple regression model predicting serum Epo lower or higher than the median retained the eGFR as an independent predictor, while serum hepcidin showed only borderline significance: Conclusion Kidney function is the main determinant of endogenous erythropoietin level in moderately anemic patients with advanced CKD, ESA or iron naive, while serum hepcidin-25 seems to exert a limited influence.

Immunoradiometric serum ferritin concentration compared with stainable bone-marrow iron as indices to iron stores.

1980 ◽  
Vol 26 (1) ◽  
pp. 145-147
Author(s):  
D T Forman ◽  
M V Vye
Keyword(s):  
Bone Marrow ◽  
Serum Ferritin ◽  
Binding Capacity ◽  
Iron Status ◽  
Clinical Value ◽  
Ferritin Concentration ◽  
Iron Stores ◽  
Specificity And Sensitivity ◽  
Bone Marrow Iron ◽  
Iron Binding Capacity

Abstract Immunoradiometric analysis has made it possible to measure ferritin reliably in serum. The determination is a sensitive means of assessing body iron because concentrations of ferritin closely parallel the body's reticuloendothelial iron stores. The information provided is similar to that obtained from bone-marrow aspirates or biopsies stained for iron with Prussian Blue. Comparative studies indicate good correlation between iron content in the marrow and serum ferritin, except possibly in patients with leukemia and metastatic tumors to the bone marrow. The clinical value of the assay in relation to other indicators of iron status (i.e., hemoglobin, erythrocyte indices, serum iron and iron-binding capacity, and erythrocyte protoporphyrin) is in its specificity and sensitivity for assaying physiological iron stores.

scholarly journals Comparison of serum iron, TIBC, transferrin saturation and serum ferritin in anemia of chronic renal diseases

2019 ◽  
Vol 7 (3) ◽  
pp. 786
Author(s):  
Veena A. ◽  
Astagimath M. N.
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Ferritin ◽  
Serum Iron ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Renal Diseases ◽  
P Value ◽  
Healthy Controls ◽  
Chronic Renal Diseases

Background: In patients with CKD and diabetes combined, anemia may be relative or absolute. If the serum ferritin is more than or equal to 100ng/ml associated with reduced iron saturation, then it is defined as functional iron deficiency anemia. This type of anemia is very common in patients with CKD. To compare serum iron, TIBC, transferrin saturation and serum ferritin in anemia of chronic renal diseases with healthy controls.Methods: A hospital based comparative study was carried out among 30 known cases of chronic kidney disease with anemia. They were compared with 20 age and sex matched healthy control who were free from chronic kidney disease and anemia. The parameters like serum iron, TIBC, transferrin saturation and serum ferritin were compared between the two groups. Student’s t test and a two tailed p value were calculated and if the p value was less than 0.05, it was taken as statistically significant.Results: It was seen that the mean hemoglobin value was significantly less among CKD patients compared to healthy controls (p<0.05). Serum iron was also significantly less among CKD patients compared to healthy controls (p<0.05). TIBC as significantly high among CKD patients compared to healthy controls (p<0.05). This is because of low hemoglobin and low serum iron in CKD patients but again the transferrin saturation was significantly low among CKD patients compared to healthy controls (p<0.05).Conclusions: Anemia prevalence was very high in CKD patients. Hemoglobin, serum iron and transferrin saturation were significantly low and TIBC was significantly high.

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