[Functional iron deficiency by percentage of hypochromic red cell in patients treated by chronic hemodialysis in Ghaem and Emam Reza hospital in 2004-2005]

ABSTRACT

The availability of recombinant human erythropoietin [rHuEPO] over the past decade has advanced the management of anemia in hemodialysis patients. However, iron deficiency either absolute or functional may be leading to failure of rHuEPO treatment. Serum Ferritin [SF] and percent of Transferrin saturation [TSAT] are regarded as the preferred indirect measurements of iron status. These tests, however, have practical limitations and lack sensitivity and specificity to identify ''functional iron deficiency'', witch can occur in the presence of normal or even increased iron stores. Newer methods of assessing iron status are available; with a percentage of hypochromic red cells [%Hypo] >2.5 have been proposed as a marker of Iron deficient erythropoiesis. It measured Hematocrit, Hemoglobin content, SF, and TSAT over 76 chronic hemodialysis patients. The percentage of hypochromic red cells was also measured in a subset of 39 patients. Functional Iron deficiency was defined as a SF > 100 micro g/1 and TSAT 8%. Indivisual characterizing and result of 1ab collected by questinnaire and analyzed by descriptive statistics. 13% of our patients had serum ferritin values > 100 micro g/1 and transferrin saturaton Iron dficiency. The percentage of hypochromic RBC [%Hypo] was > 8% in 80% of our patients at this group. It observed a significant difference in Transferrin saturation [p=0.000] and %Hypo [p=0.001] in these two groups. The diagnostic sensitivity and specificity of %Hypo > 8% in detecting functional Iron deficiency were 80% and 79% respectively. In hemodialysis patients on rHuEPO therapy, Hypo > 8% is a sensitive available marker to identify functional iron deficient patients