Evaluation of iron status in anemic pre-dialysis chronic kidney disease patients

Niger J Clin Pract. 2022 Mar;25(3):226-230. doi: 10.4103/njcp.njcp_234_19.

Abstract

Background: Data on iron status are generally less readily available in pre-dialysis chronic kidney disease (CKD) patients than in the hemodialysis population. In Nigeria, little is known about iron indices in patients with CKD.

Aims: The aim of this study was to evaluate the iron status among anemic pre-dialysis patients with CKD.

Patients and methods: Using a cross-sectional study design, we evaluated serum ferritin and transferrin saturation (TSAT) among 63 pre-dialysis CKD patients with anemia attending our outpatient nephrology clinic. CKD was defined as a glomerular filtration rate less than 60 ml/min/1.73 m2 for 3 months or more, while anemia was defined as a hemoglobin concentration (Hb) less than 11 g/dl.

Results: The mean age of the study participants was 52.5 ± 12.7 years and 33 (52.4%) of the patients were females. The most common causes of CKD were hypertension (44.4%) and diabetic nephropathy (30.6%). The mean Hb, mean serum ferritin, and mean TSAT were 9.2 ± 1.1 g/dl, 106.6 ± 72.7 ng/ml, and 24.3% ± 7.9%, respectively. There was no significant difference in median ferritin (91[interquartile range: 54-133] ng/ml versus 106 [interquartile range: 45-151; P=0.75) and mean TSAT (24.9 ± 7.2 % versus 23.8 ± 7.7 %; P=0.54) between male and female study participants; Half (50.8%) of the study participants had absolute iron deficiency (serum ferritin <100 ng/ml) and 6.3% had functional iron deficiency (ferritin >100 ng/ml and TSAT <20%).

Conclusion: Iron deficiency is common among anemic adult Nigerian pre-dialysis CKD patients. Results of iron studies should guide therapy when correcting anemia in these patients.

Keywords: Anemia; chronic kidney disease; serum ferritin; transferrin saturation.

MeSH terms

  • Adult
  • Aged
  • Anemia* / epidemiology
  • Anemia* / etiology
  • Cross-Sectional Studies
  • Dialysis / adverse effects
  • Female
  • Humans
  • Iron
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic* / epidemiology

Substances

  • Iron