Soluble transferrin receptor and ferritin index in evaluation of iron metabolism in hemodialysis patients

Abstract

THE AIM: to study features of ferrokinetic in hemodialysis patients according to the level of soluble receptors of transferrin and ferritin index. PATIENTS AND METHODS. Research included 100 patients with chronic kidney disease 5D stage receiving hemodialysis, among them 51 women and 49 men, mean age was 53,4±15,8 years. All patients were performed complex clinical and laboratory tests. RESULTS. The increasing concentration of soluble transferrin receptors was observed in 44% of patients that can be caused by iron deficiency and increased erythropoiesis in response to therapy with erythropoietin. The level of hemoglobin is not varied depending on the concentration of soluble transferrin receptors. The estimation of genesis of anemia based on the ferritin index allowed to identify a higher frequency of anemia of chronic disease (92,5%) than using the traditional approach based on the level of ferritin and transferrin saturation (functional iron deficiency in 9% of patients). The combination of anemia in chronic disease with iron deficiency associated with low iron concentration and a high level of hepcidin. The negative role of hypoalbuminemia on the iron level, transferrin saturation and soluble receptor of transferrin was demonstrated (p<0.05). CONCLUSION. In dialysis patients for a comprehensive evaluation of iron metabolism, it is advisable to perform a study of soluble transferrin receptors and the calculation of ferritin index, which allow to assess the anemic syndrome formation pathogenetic mechanisms.