The value of soluble transferrin receptor in early diagnosis of iron deficiency anemia in chronic renal failure

الملخص EN

Decreased erythropoietin (EPO) production is the main pathogenic factor of anemia in chronic renal failure (CRF).

Iron deficiency is the most common cause of EPO resistance in dialyzed patients with renal failure.

Subclinical or functional iron deficiency is difficult to diagnose in these patients.

Aim: This study was designed to determine the sensitivity and specificity of serum iron, transferrin, ferritin and soluble serum transferrin receptor (sTFR) in iagnosis of iron deficiency in chronic renal failure and the efficacy of recombinant human EPO (rHuEPO) treatment.

Patients: This study was conducted on 70 patients with CRF divided into three groups: group (A) CRF patients predialysis (30 cases), group (B) CRF patients on regular dialysis > 5 years (30 cases), and group (C) CRF patients on dialysis and rHuEPO treatment with parentral iron supplementation (10 cases).

Twenty healthy individuals age and sex matched were included as controls.

Methods: Peripheral hemogram, serum urea and creatinine, serum iron (SI) and total iron binding capacity (TIBC), serum ferritin, serum transferrin and (sTFR) were done for both patients and control groups.

Results: There was highly significant reduction of RBCs, hemoglobin (Hb) and hematocrit (Hct) in different patients groups compared to controls; (P<0.001) for each.

Serum iron (SI) was insignificantly reduced in groups A and B compared to controls while it was significantly increased in group C (P<0.05).

Serum transferrin was significantly reduced in all patients groups compared to controls (P<0.001) for each.

Serum ferritin and sTFRwere significantly increased in both group A and B(P<0.001) for each, while in group C, there was significant increase in serum ferritin (P<0.01) and no significant difference in sTFR level compared to controls.

Conclusion: sTFR is a sensitive (sensitivity 93%) and specific (specificity 100%) indicator for identifying iron deficiency and assessing the effect of rHuEPO treatment in CRF patients.