Background: Renal failure causes anemia for many. Serum iron and transferrin saturation indicate hemoglobin synthesis iron availability. Total body iron is measured by serum ferritin. For optimal recombinant human erythropoietin benefit, adequate iron reserves are needed. Recombinant erythropoietin success depends on iron status assessment. The study aims to evaluate the effectiveness of traditional indicators (serum iron, total iron binding capacity, transferring saturation, and serum ferritin) in monitoring body iron status and determining the impact of recombinant human erythropoietin therapy on end-stage renal disease patients.
Methods: From June 1 to November 10, 2010, 40 end-stage renal disease patients on regular hemodialysis from Medical City's Renal Transplant Centre and Dialysis Unit participated in this study. We obtained clinical data. Manually measured blood iron, total iron binding capacity, transferrin saturation, ferritin, albumin, creatinine, and C-reactive protein. 30 healthy people were in the control group.
Results: End stage renal disease (ESRD) patients had a mean age of 45.1 years, with 60% being male. They exhibited significantly lower PCV (25.3%) and higher platelet and WBC counts compared to healthy controls. High serum ferritin was seen in 72.5% of patients, while 37.5% had functional iron deficiency. ESRD was associated with lower serum albumin and higher serum creatinine levels, with significant correlations between PCV, serum albumin, and serum creatinine.
Conclusion: About 72.5% of end stage renal disease (ESRD) patients had high serum ferritin (≥300 ng/ml), which was not a reliable index for iron stores and indicated an acute phase response. Combining transferrin saturation and serum ferritin showed low sensitivity in diagnosing iron status, determining iron status in only 47.5% of ESRD patients. The coexistence of anemia of chronic disorder and iron deficiency obscures the effectiveness of classical indices in assessing body iron status.
