epidemiological profile of anemia, blood transfusions and iron overload in paitients on maintenance dialysis

ABSTRACT

Anaemia contributes considerably to morbidity and impairs the quality of life in patients on maintenance dialysis [MD]. This study analyzed the epidemiological profile of anaemia, transfusional requirements [TR] and iron stores in patients on MD in Kuwait during 1989-1990. In those years, recombinant erythropoietin [rHuEPO] therapy had just been initiated. One hundred and eighty-nine patients were studied. Forty four [28.8%] patients were found to be severely Anaemic and/or required excessive blood transfusions, 25 of whom were receiving maintenance haemodialysis [MHD]] for <18 months. During the first 18 months of dialysis, 33% of MHD] patients were found to be iron depleted i.e. serum ferritin [SF] <30 micro g/l, compared to only <2% of MHD patients on longer duration of dialysis, and 0% of those on maintenance peritoneal dialysis [MPD]. Twenty six [13.8%] patients were Iron overloaded [10] [SF>1100 micro g/I] of whom 24 were receiving MHD]. Iron stores correlated positively with duration on dialysis only In those who exhibited excessive TR Our study emphasize the need for periodic assessment and replenishment of iron stores especially during the early months of MHD. Early application of iron monitoring and use of rHuEPO will limit the need for blood transfusions and prevent the development of 10 in this patient population