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

scholarly journals GAMBARAN STATUS BESI PADA PASIEN PENYAKIT GINJAL KRONIK YANG MENJALANI HEMODIALISIS

e-CliniC ◽  
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.

The problem with transferrin saturation as an indicator of iron ‘sufficiency’ in chronic kidney disease

2020 ◽  
Author(s):  
Anatole Besarab ◽  
Tilman B Drueke
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Iron Metabolism ◽  
Iron Status ◽  
Hypoxia Inducible Factor ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Iron Availability ◽  
Inflammatory State

Abstract After a brief review of physiological iron metabolism, we describe diagnostic tests for iron status and iron deficiency anemia in patients without chronic kidney disease (CKD) or inflammation. Thereafter we review the dysregulation of iron metabolism in CKD. Specific emphasis is placed on the role of the ‘inflammatory’ state that develops with the progression of CKD. It invokes changes in iron metabolism that are the exact opposite of those occurring during pure iron deficiency. As a result, transferrin saturation (TSAT) becomes a poorer index of iron availability to the bone marrow and serum ferritin no longer represents iron that can be used during erythropoiesis. We argue that serum iron may provide more information to guide iron therapy than TSAT. In other words, the emphasis on TSAT is misplaced. With the development of a number of hypoxia-inducible factor prolyl hydroxylase inhibitors, which restore iron metabolism toward the ‘physiologic state’, the iron indices indicating sufficient iron availability to avoid functional iron deficiency during therapy of CKD-associated anemia are likely to change. We summarize these changes in the section ‘A peek into things to come!’, citing the available data.

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 Gambaran Anemia pada Subjek Penyakit Ginjal Kronik Stadium 4 dan 5 di Poliklinik Ginjal-Hipertensi RSUP Prof. Dr. R. D. Kandou

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Yordhan Tamsil ◽  
Emma Sy. Moeis ◽  
Frans Wantania
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medical Records ◽  
Iron Status ◽  
Descriptive Study ◽  
Transfusion Therapy ◽  
Female Age ◽  
Stage 4 ◽  
Almost All ◽  
Age Range

Abstract: Anemia is a complication of chronic kidney disease (CKD) that often occurs. Moreover, it can occur earlier than other complications of CKD in almost all patients with late stage kidney disease. This study was aimed to obtain the profile of anemia in subjects with stage 4 and 5 of chronic kidney disease. This was a retrospective and descriptive study using medical records of patients with CKD associated with anemia for two years. The results showed that of 428 CKD patients, 131 suffered from anemia (30.60%). The majority of patients were female (54.19%), age range 60-69 years (44.27%), non-dialysis stage 5 of CKD patients (74.04%), had sufficient iron status (79.38%). However, 15,26% of the 131 patients got blood transfusion therapy. In conclusion, the majority of CKD patients were stage 5 ND, female, age range of 60-69 years, had sufficient iron status, and were not treated with blood transfusion.Keywords: chronic kidney disease, anemia Abstrak: Anemia merupakan komplikasi penyakit ginjal kronik (PGK) yang sering terjadi, bahkan dapat terjadi lebih awal dibandingkan komplikasi PGK lainnya dan hampir pada semua pasien penyakit ginjal tahap akhir. Penelitian ini bertujuan untuk mengetahui gambaran anemia pada subyek penyakit ginjal kronik stadium 4 dan 5 di Poliklinik Ginjal-Hipertensi RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah metode deskriptif retroskpektif dengan mengunakan data rekam medik pasien PGK dengan anemia selama dua tahun. Hasil penelitian memperlihatkan dari 428 pasien PGK didapatkan 131 pasien dengan anemia pada PGK (30,60%). Mayoritas pasien ialah jenis kelamin perempuan (54,19%), usia 60-69 tahun (44,27%), dan PGK derajat 5 non-dialisis (74,04%), memiliki status besi cukup (79,38%). Terdapat 15,26% dari pasien yang mendapatkan terapi transfusi darah. Simpulan penelitian ini ialah pasien terbanyak dengan derajat 5 ND, jenis kelamin perempuan, rentang usia 60-69 tahun, dengan status besi cukup, dan tidak mendapat terapi transfusi darah.Kata kunci: penyakit ginjal kronik, anemia

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

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.

High Prevalence of Iron Deficiency In Anemic and Non Anemic Patients with Various Types of Cancer

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5145-5145
Author(s):  
Heinz Ludwig ◽  
Georg Endler ◽  
Brigitte Klement ◽  
Wolfgang Hüubl ◽  
Tim Cushway
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Multiple Testing ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Complete Blood Count ◽  
Clinical Symptoms ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Patients With Cancer

Abstract Abstract 5145 Introduction and aims: Iron deficiency as a major component in the pathogenesis of anemia in cancer is not acknowledged by most oncologists, possibly except when arising from GI blood loss. Iron deficiency is associated with clinical symptoms such as cognitive impairment, fatigue, and reduced exercise performance. New iron formulations are available that allow rapid iron supplementation with single infusions. This treatment could ameliorate symptoms of iron deficiency and correct anemia. Here, we studied iron parameters and their correlation with erythropoiesis and inflammatory markers in a large unselected cohort of patients with cancer. In addition, we investigated the suitability of serum ferritin and transferrin saturation (TSAT) as parameter for assessment of the iron status. Patients and methods: Data from 1627 patients (median age: 66.4 years, range: 20–97 years) presenting sequentially at the Center for Oncology and Hematology, Wilhelminenspital, Vienna between October 01, 2009 and January 26, 2010, have retrospectively been analyzed. Patients were at different stages of their disease or may not have had an established diagnosis at the time of testing. In patients with multiple testing during this period only the first sample taken was included. TSAT (n=1516), serum ferritin (n=887), serum iron, CRP, and complete blood count, were determined by using standard techniques. Commonly used definitions for absolute iron deficiency (AID), [TSAT <20% and serum ferritin <30ng/ml, in case serum ferritin was not available TSAT <10%] and for functional iron deficiency (FID), [TSAT <20% and serum ferritin ≥30ng/ml, in case serum ferritin was not available TSAT between 10 and 20%] have been applied. Fisher's exact test was used for comparison of frequencies and Pearson's product moment correlation coefficient for evaluation of correlation. Results: Table 1 shows the distribution of TSAT and serum ferritin categories in 1627 patients with cancer. AID was found in 116 patients (7.7%) of the 1516 patients for whom TSAT was available. Eighty-three (72%) of the AID patients presented with anemia (defined by hemoglobin <12g/dl). AID was most common in patients with colorectal and pancreatic cancer (12% and 11%, respectively), and not present in patients with testicular and prostate cancer (p=0.013). FID was diagnosed in 530 patients (35%) and 222 (42%) of them were found to be also anemic. Multivariate analysis revealed a statistically significant correlation between TSAT and serum ferritin (R=0.286, p<0.001), serum iron (R=0.874, p<0.001), hemoglobin (R=0.201, p<0.001) and CRP (R=-0.205, p<0.001) (figure 1). Serum ferritin, in contrast, did not correlate with serum iron (R=0.051, p=0.132), but correlated with hemoglobin (R=-0.259, p<0.001), TSAT (R=0.286, p<0.001), and CRP (R=0.396, p<0.001). Conclusion: AID (7.7%) and even more so FID (35%) are frequent co-morbidities in patients with various types of cancer. Seventy-two percent of patients with AID and 42% with FID presented with overt anemia. TSAT correlated closely with serum iron and hemoglobin levels and seems to be the preferred parameter for assessment of iron status in patients with chronic diseases often complicated by increased inflammation. Serum ferritin was found to be an inadequate parameter for assessment and monitoring of iron status. As iron deficiency has been linked with various symptoms, the question arises whether iron supplementation would benefit patients with FID without overt anemia. Future studies should evaluate the role of novel intravenous iron preparations in ameliorating the symptoms of iron deficiency with or without anemia. Disclosures: Klement: Vifor Pharma Ltd: Employment. Cushway:Vifor Pharma Ltd.: Employment.

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.

scholarly journals Iron Age or New Age: Ironing out the Diagnosis of Anaemia of Inflammation from Iron Deficiency Anaemia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3354-3354
Author(s):  
Nicola J Svenson ◽  
Russell Patmore ◽  
Heidi J Cox ◽  
James R Bailey ◽  
Stephen Holding
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Serum Iron ◽  
Iron Status ◽  
Diagnostic Testing ◽  
Transferrin Saturation ◽  
Oral Iron ◽  
Gastrointestinal Disorders ◽  
Serum Hepcidin ◽  
Iron Parameters

Abstract Introduction Iron deficiency anaemia (IDA) and anaemia of chronic inflammation (AI) are the most prevalent causes of iron related anaemia in subjects with gastrointestinal disorders contributing significantly to morbidity and mortality. Diagnosis of IDA and AI is not always straight forward and currently a combination of several serum parameters (ferritin, transferrin, transferrin saturation, iron and C-reactive protein) is required. Subjects with a mixed aetiology can be difficult to interpret using traditional serum parameters, particularly in the presence of an inflammatory process. Hepcidin (a 25 amino-acid peptide hormone) in conjunction with reticulocyte haemoglobin equivalent (RetHe) has the potential to differentiate IDA from AI and in cases of mixed aetiology replacing the traditional laboratory parameters (serum iron, CRP, transferrin saturation and ferritin). Aim The aim of the study was to evaluate the performance of a commercially available ELISA assay and investigate whether hepcidin and RetHe can differentiate AI from mixed aetiology. Method The study investigated 77 patients with gastrointestinal disorders associated with anaemia in a secondary care setting using a traditional pathway of 6 tests (figure 1): Complete Blood Count (CBC), Reticulocytes, serum ferritin, CRP, transferrin, serum Iron. Hepcidin concentration was measured using a commercially available ELISA method (DRG Diagnostic GmbH, Marburg, Germany), CBC and RetHe using a Sysmex XE-2100 CBC analyser, iron parameters and CRP using Beckman Coulter platforms. Results Hepcidin correlated well with ferritin R2 = 0.79, p<0.0001. The results were compared to traditional parameters with Receiver Operator Curves (ROC) used to determine diagnostic cut off concentrations (table 1). Table 1. Sensitivity and specificity of serum ferritin and serum hepcidin used to determine diagnostic cut off values. Selected cut off values IDA AI Serum ferritin 30.0µg/L Sensitivity 83% Specificity 64% Sensitivity 55% Specificity 75% Serum hepcidin 8ng/mL Sensitivity 73% Specificity 72% Sensitivity 70% Specificity 67% Serum hepcidin 40ng/mL Sensitivity 98% Specificity 32% Sensitivity 25% Specificity 91% Ferritin was unable to distinguish IDA from AI in mixed aetiology situations. This gives rise to a new proposed 2 step pathway (figure 2) using 3 tests: CBC, RetHe and hepcidin differentiating IDA from AI in mixed aetiology cases indicating the cause of the anaemia. The RetHe value can then be used to predict the response to oral iron. Conclusion Serum hepcidin may not yet replace serum ferritin as the preferred iron status marker, but in conjunction with RetHe it may distinguish mixed aetiology subjects. This offers the potential development of a clearer clinical pathway for investigation of difficult subjects, including reduction in the number of tests required during anaemia investigations and shorter diagnosis times. The advantage of hepcidin together with RetHe over traditional iron parameters is both as a real time marker of iron status and an indication of likelihood of response to iron therapy. The patient would benefit from a shorter recovery time, unnecessary testing, reduction in ineffective treatment and overall reduction in costs. Figure 1. Current diagnostic testing pathway using 6 independent tests with serum ferritin used as the primary indicator of iron stores. Figure 1. Current diagnostic testing pathway using 6 independent tests with serum ferritin used as the primary indicator of iron stores. Figure 2. Suggestion of a new 2 step diagnostic testing pathway with serum hepcidin as the primary indicator and reticulocyte haemoglobin equivalent as the predictor of iron deficiency and response to oral iron. Figure 2. Suggestion of a new 2 step diagnostic testing pathway with serum hepcidin as the primary indicator and reticulocyte haemoglobin equivalent as the predictor of iron deficiency and response to oral iron. Disclosures Patmore: Janssen: Honoraria; Gilead: Honoraria.

scholarly journals Correlation between vivax malaria infection and iron deficiency in children

2015 ◽  
Vol 55 (1) ◽  
pp. 44
Author(s):  
Desmansyah Desmansyah ◽  
Rini Purnamasari ◽  
Theodorus Theodorus ◽  
Sulaiman Waiman
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Vivax Malaria ◽  
Malaria Infection ◽  
Serum Iron ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Hemoglobin Level ◽  
Ferritin Concentration ◽  
Iron Deficient

Background Iron deficiency is considered to be a major public health problem around the world due to its high prevalence as well as its effect on growth, development, and infection-resistance in children. In malaria-endemic areas, malaria infection is thought to contribute to the occurrence of iron deficiency, by means of hepcidin and hemolysis mechanisms. Objective To assess the prevalence of asymptomatic vivax malaria, compare hemoglobin levels and iron status parameters between vivax malaria-infected and uninfected children, assess the prevalence of iron deficiency, and evaluate a possible correlation between vivax malaria infection and iron deficiency. Methods This cross-sectional study was conducted from February to April 2013 at Sanana City of Sula Islands District, North Maluku. Six parameters were evaluated in 5-11-year-old children: malaria parasite infection, hemoglobin level, serum iron concentration, total iron-binding capacity (TIBC), serum transferrin saturation, and serum ferritin concentration. Results Among 296 children aged 5-11 years, 75 (25.3%) were infected with Plasmodium vivax. In infected children, hemoglobin, serum iron, transferrin saturation, TIBC and serum ferritin were significantly lower than in non-infected children (P<0.01). Using a serum ferritin cut-off of <15 μg/dL, 142 (48.0%) of the children were found to be iron deficient. There was a strong correlation between vivax malaria infection and iron deficiency (OR 3.573; 95%CI 2.03-6.29). ConclusionThe prevalence of asymptomatic vivax malaria infection was 25.3%. The hemoglobin level and iron status parameters in vivax malaria-infected subjects were significantly lower than in uninfected children. The prevalence of iron deficiency was 48.0% for all study subjects. Malaria vivax infection was correlated with iron deficiency in 5-11-year-old children at Sanana City.

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