Evaluation of Iron Storage Status and Iron Deficiency Anemia in Chronic Kidney Disease Patients in Pre-dialysis and Preserving Hemodialysis Stages

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Abstract

  Background and Objective: Anemia is one of the major disabling consequences in chronic kidney (CKD) disease which has different etiologies .Inadequate production of Erythropoietin (EPO) is the main cause of anemia. Iron shortage is the other important cause. The aim of this study is to evaluate Anemia Prevalence and iron storage in CKD patients in pre-dialysis and hemodialysis stages.   Materials and Methods: This cross-sectional descriptive- analytic study was conducted on 90CKD patients(54 hemodialyzed,36 pre-dialyzed)at Mustafa Khomeini Hospital, Tehran, Iran. Lab data including : serum iron(SI) and ferritin, transferrin saturation(TSAT) and red cell indices(RCI) were measured. All data analysis were carried out using, the SPSS 16.   Results: Frequency of anemia in hemodialyzed and pre-dialyzed patients were 79.6 % and 75 %. Iron deficiency anemia (IDA), absolute and functional iron deficiency were found 11.1 %, 11.1 % and 24.1 %in turn in hemodialyzed and 5.6 %, 8.3 % and 30.6 %in turn in pre-dialyzed patients. There was not significant statistical relationship between CKD causes,hemodialysis duration, anemia symptoms and iron deficiency anemia (P=0.07). TSAT and Hg were higher in patients receiving intravenous iron in comparison with oral iron(P < 0.001).Functional iron deficiency had a meaningful correlation with erythropoietin(EPO) usage in both groups(p < 0.001)   Conclusion: Intravenous iron is preferred for iron deficiency treatment in comparison with oral ones. Red cell distribution width and RCI are not appropriate markers for IDABy themselves. In CKD,serum ferritin and iron (sensitivity 46.34 %, 43.90 %) Are not useful indices to evaluate iron stores precisely, but TSAT (sensitivity 73.17%) seems more reliable.  

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Daneshvar Medicine
Volume 16, Issue 2 - Serial Number 81
July and August 2009
Pages 17-22

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