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A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
05:35

A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level

Published on: January 19, 2024

Decisive indicator for gastrointestinal workup in anemic patients with nondialysis chronic kidney disease

Hyeon Seok Hwang1, Youn Mi Song, Eun Oh Kim

  • 1Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

International Journal of Medical Sciences
|October 12, 2012
PubMed

Insights

Transferrin saturation (TSAT) effectively identifies gastrointestinal bleeding in anemic chronic kidney disease (CKD) patients. Stage 5 CKD patients require cautious TSAT interpretation due to higher lesion prevalence.

Area of Science:

  • Nephrology
  • Gastroenterology
  • Hematology

Background:

  • Anemia and iron deficiency are common in chronic kidney disease (CKD).
  • A definitive marker to guide gastrointestinal (GI) investigation in these patients is lacking.

Purpose of the Study:

  • To evaluate the diagnostic utility of laboratory markers for identifying bleeding-related GI lesions in anemic CKD patients.
  • To determine if specific CKD stages influence the prevalence of GI lesions.

Main Methods:

  • 104 anemic patients with nondialysis-dependent CKD stages 3-5 were included.
  • Assessed hemoglobin, serum ferritin, transferrin saturation (TSAT), mean corpuscular volume (MCV), and corrected reticulocyte count.
  • GI lesions were identified via esophagogastroduodenoscopy and colonoscopy.

Main Results:

  • Bleeding-related GI lesions were found in 52.9% of patients; stage 5 CKD showed higher gastric lesion prevalence.
  • TSAT demonstrated significant diagnostic utility (AUC 0.69, p=0.002) for predicting lesions.
  • Lower TSAT (<20%) had 59% sensitivity and 74% specificity; hemoglobin, MCV, and reticulocyte counts were not significant.

Conclusions:

  • TSAT is a valuable indicator for guiding GI workup in anemic CKD patients (stages 3-5).
  • Stage 5 CKD is independently linked to bleeding-related GI lesions.
  • TSAT should be interpreted with caution in stage 5 CKD patients.
Abstract

Keywords:
Chronic kidney diseaseanemiaendoscopy

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