Evaluation of iron status in anemic pre-dialysis chronic kidney disease patients

Data on iron status are generally less readily available in pre-dialysis chronic kidney disease (CKD) patients than in the hemodialysis population. In Nigeria, little is known about iron indices in patients with CKD.

The aim of this study was to evaluate the iron status among anemic pre-dialysis patients with CKD.

Using a cross-sectional study design, we evaluated serum ferritin and transferrin saturation (TSAT) among 63 pre-dialysis CKD patients with anemia attending our outpatient nephrology clinic. CKD was defined as a glomerular filtration rate less than 60 ml/min/1.73 m² for 3 months or more, while anemia was defined as a hemoglobin concentration (Hb) less than 11 g/dl.

The mean age of the study participants was 52.5 ± 12.7 years and 33 (52.4%) of the patients were females. The most common causes of CKD were hypertension (44.4%) and diabetic nephropathy (30.6%). The mean Hb, mean serum ferritin, and mean TSAT were 9.2 ± 1.1 g/dl, 106.6 ± 72.7 ng/ml, and 24.3% ± 7.9%, respectively. There was no significant difference in median ferritin (91[interquartile range: 54-133] ng/ml versus 106 [interquartile range: 45-151; P=0.75) and mean TSAT (24.9 ± 7.2 % versus 23.8 ± 7.7 %; P=0.54) between male and female study participants; Half (50.8%) of the study participants had absolute iron deficiency (serum ferritin <100 ng/ml) and 6.3% had functional iron deficiency (ferritin >100 ng/ml and TSAT <20%).

Iron deficiency is common among anemic adult Nigerian pre-dialysis CKD patients. Results of iron studies should guide therapy when correcting anemia in these patients.