Soluble transferrin receptors [sTFR] as a marker for iron deficiency in patients with end stage renal disease undergiong maintenance haemodialysis

ABSTRACT

In the present work, 27 patients were considered iron deficient [Group I; haemoglobin increased by 1.49 +/- 0.3 g/dl and transferrin saturation <20%] and 39 patients as iron replete [Group II; haemoglobin increased by 1.0 +/- 0.21 g/dl and transferrin saturation >20%]. Group I had significant lower haemoglobin, ferritin and Tsat levels and higher EPO dose, transferrin and sTFR concentration compared to group II. After i.v. iron therapy, there was a significant elevation of serum ferritin and Tsat levels and significant decrease in serum transferrin level in both iron deficient and iron replete group. In contrast, sTFR concentration significantly decreased in group I. Statistical analysis of the results revealed that all parameters of iron indices can differentiate between the two types of the iron status by a variable degree; sTFR [sensitivity 81.1%, specificity 75.4% at cut-off >1.9 mg/L], serum transferrin saturation [sensitivity 59.4, specificity 73.9% at cut-off <20%] and serum ferritin [sensitivity 35.3%, specificity 71.2% at cut-off < 100 ng/ml]. Neither transferrin saturation [Tsat] nor serum ferritin concentrations were indicative of EPO requirements. A highly significant correlation between the EPO efficacy index [EPO dose divided by haemoglobin concentration] and sTFR was observed