Iron Status in Patients with Chronic Renal Failure on Haemodialysis
Iraqi Postgraduate Medical Journal,
2006, Volume 5, Issue 3, Pages 318-324
Anaemia is common in renal failure. Serum iron (SI), and the percentage of transferrin saturation
(TSAT) reflect the amount of iron immediately available for haemoglobin (Hb) synthesis. Serum
ferritin level reflects total body iron stores. Adequate iron stores are essential for achieving maximum
benefit from recombinant human erythropoietin (Epo). A low level of either of these indices may
indicate the need for supplement iron to support erythropoiesis.
Seventy Patients with end stage renal disease (ESRD) on regular haemodialysis (HD) were included in
this study from three dialysis centers in Baghdad: We have collected data on, serum iron, total iron
binding capacity (TIBC), TSAT, Serum ferritin, and blood film, was done. Fifty subjects were included
in the control group.
A44 patients (62.9%) were receiving regular parenteral Iron Dextran with Epo, and 26 patients (37.1%)
were receiving irregular oral or intramuscular iron Dextran with Epo. According to the serum ferritin,
41 patients (58.6%) involved have serum ferritin level >300ng/ml, of them; the TSAT was > 20% in
27 patients while TSAT ≤ 20% in 14 patients in this group, and Hb was > 11 g/dl in 11 patients where
as ≤ 11 g/dl in 30 patients in this group. Serum ferritin in 29 patients (41.4%) was ≤ 300 ng/ml, of them, the TSAT was ≤ 20% in 26 patients and > 20% in three patients only, the Hb level was ≤ 11 g/dl
in all patients in this group. There was significant correlation with anaemia. (Hb ≤ 11 g/dl) and low
serum ferritin (P<0.005), patients with TSAT ≤ 20%, all were anaemic (Hb≤11 g/dl) and there was a
significant association between these two markers (P<0.005). In patients receiving regular parenteral
iron and Epo (44 patients) (62.9%), the TSAT was > 20% in 21 patients (30%), while those who taking
no or irregular iron therapy with Epo (26 patients) (37.1%), the STAT was >20% in 9 (12.9%) the difference was not statically significant.
The serum ferritin in our study group was higher than that reported in other studies. Serum ferritin of ≤
300 ng/ml, and TSAT of≤ 20% in our study group was significantly correlated with anaemia. Serum
ferritin of ≤ 300 ng/ml and a TSAT of≤ 20% were significantly associated.
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