Naslov
Korisnost određivanja topljivih transferinskih receptora i saturacije transferina u dijagnostici manjka željeza kod bolesnika na dijalizi s povišenim feritinom
(Utility of the serum soluble transferrin receptors and transferrin saturation in iron deficiency diagnosis in hemodialysis patients with high serum feritine level)

Autori
Šefer, Siniša ; Szavits-Nossan, Janko ; Degoricija, Vesna ; Gaćina, Petar

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Acta Medica Croatica 2005 ; 59: (suppl 2) / Kučišec-Tepeš, Nastja - Zagreb : Akademija medicinskih znanosti Hrvatske, 2005, 84-84

Skup
Četvrti Hrvatski kongres nefrologije, dijalize i transplantacije s međunarodnim sudjelovanjem

Mjesto i datum
Rovinj, Hrvatska, 07.10.2005. - 10.10.2005

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
anaemia; transferrine receptors; eritropoietine

Sažetak
Aim: To determine the diagnostic value of serum soluble transferrin receptors (sTfR) and transferrin saturation (TSAT) in solving the dilemma of the existence of a true iron deficiency in haemodialysis patients with high ferritin levels and who are being treated with eritropoietine (Epo). Subjects and methods: Included in the study are 19 patients on dialysis whose anaemia is planned to be treated with Epo s.c. (Recormon&#61650; ). Prior to treatment with Epo all subjects met the following conditions: Hb<100g/L, feritin>600&#61549; g/mL, TSAT>20% and sTfR<3.3 (norm. 1.3-3.3 mg/L). During the first two months of treatment, subjects were not given iron preparations. All subjects were given vitamin B12, vitamin C and folic acid in adequate dosages. After two months of Epo treatment, Hb, Rtc, MCV, TSAT, feritine, sTfR, CRP were determined and the Epo/Hb index was calculated for all subjects. The Epo/Hb index was defined as a ratio of the number of weekly units of Epo per kilogram of body weight of a subject and the Hb concentration for the same subject. In 14 subjects for which the expected increase of Hb (Hb<110g/L) was not noticed, despite the application of an adequate dosage of Epo (Epo/Hb>1), with a decrease of TSAT<20% and an increase of sTfR>3.3 mg/L (a sign of iron deficiency), and despite feritine>600&#61549; g/mL, iron was supplemented i.v. (Ferrlecit&#61650; 2x weekly 62.5 mg). After two months from the start of providing iron supplements, the same biochemical and haematological tests were performed again. Results: Results are summarized in Table 1. Conclusion: sTfR and TSAT are better indicators of iron deficiency in patients on dialysis than feritine alone. The increased level of feritine in patients on dialysis with a high level of CRP is probably the consequence of an inflammation and not a true indicator of the status of iron. The lack of a heightened concentration of sTfR even after supplementing iron is a reflection of stimulated eritropoiesis with Epo therapy, which is backed by the increase in the number of Rtc and a decrease of the Epo/Hb index. The reflection of a stimulated eritropoiesis is also an increase in MCV caused by the increased number of Rtc. Seeing as the increased level of sTfR can be a reflection of a lack of iron and/or a stimulated eritropoiesis, a diagnostic method for diagnosing an iron deficiency in these patients can be the determination of the TSAT alone.

Izvorni jezik
Hrvatski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA