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

ABSTRACT

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, transferring, ferritin and soluble serum transferrin receptor [sTFR] in diagnosis 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. Peripheral hemogram, serum urea and creatinine, serum iron [SI] and total iron binding capacity [TIBC], serum ferritin, serum transferring and [sTFR] were done for both patients and control group. 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]. Serw transferrin was significantly reduced in all patients groups compared to controls [P < 0.001] for each. Serum ferritin and sTFR were 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. 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