Iron Status in Patients with Chronic Renal Failure on Haemodialysis

Abstract

ABSTRACT:BACKGROUND: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. Serumferritin level reflects total body iron stores. Adequate iron stores are essential for achieving maximumbenefit from recombinant human erythropoietin (Epo). A low level of either of these indices mayindicate the need for supplement iron to support erythropoiesis.METHODS:Seventy Patients with end stage renal disease (ESRD) on regular haemodialysis (HD) were included inthis study from three dialysis centers in Baghdad: We have collected data on, serum iron, total ironbinding capacity (TIBC), TSAT, Serum ferritin, and blood film, was done. Fifty subjects were includedin the control group.RESULTS: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% in27 patients while TSAT ≤ 20% in 14 patients in this group, and Hb was > 11 g/dl in 11 patients whereas ≤ 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/dlin all patients in this group. There was significant correlation with anaemia. (Hb ≤ 11 g/dl) and lowserum ferritin (P<0.005), patients with TSAT ≤ 20%, all were anaemic (Hb≤11 g/dl) and there was asignificant association between these two markers (P<0.005). In patients receiving regular parenteraliron and Epo (44 patients) (62.9%), the TSAT was > 20% in 21 patients (30%), while those who takingno or irregular iron therapy with Epo (26 patients) (37.1%), the STAT was >20% in 9 (12.9%) the difference was not statically significant.CONCLUSION: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. Serumferritin of ≤ 300 ng/ml and a TSAT of≤ 20% were significantly associated.