Non-Heme Iron Panel in Patients with Anemia and Chronic Kidney Disease

Abstract

The objective of the study: to improve the quality of diagnosis of anemia of renal origin by studying the non-heme iron state in patients with different stages of chronic kidney disease (CKD). Material and methods: the study included 79 patients with CKD (28 – male, 51 – female) 33-72 years old. The patients were divided into two groups: group I included 24 patients without anemia, group II included 55 patients with anemia. Patients of group II were divided into 3 subgroups: 31 patients– with mild degree of anemia (subgroup 1), 18 patients – moderate degree (subgroup 2), 6 patients – severe degree (subgroup 3). The control group consisted of 20 healthy people. A complete hematology panel, urine tests, kidney ultrasound, serum urea and creatinine levels, glomerular filtration rate (GFR) by MDRD were performed. The serum iron levels, total and latent serum iron ability by ferritin and transferrin levels were measured. Results: among patients CKD of II-III stages in 67% of cases and CKD of IV-V stages in 33% of cases were revealed. Anemia of mild degree was revealed in 56% of cases; moderate degree in 33% and severe degree in 11% of cases. It was found that in the case of anemia of renal origin serum creatinine and urea levels increased, and decreased GFR, serum hemoglobin, hematocrit, iron, transferrin, and ferritin levels deceased also. Intensive change of these parameters was the most pronounced in patients with severe anemia. This was confirmed by exiting positive correlations between hemoglobin and serum iron and transferrin levels. Conclusions: iron deficiency in the body is an important branch of the anemia pathogenesis in patients with CKD. For the diagnosis of anemia and its severity degree we should  consider not only hemoglobin levels but the indicators of non-heme iron status in the patients with CKD. Decreasing serum iron, transferrin and ferritin levels determine severity of anemia and CKD. The lowest non-heme iron levels are typical for patients with CKD of IV-V stages and severe anemia.
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