107 - Assessment of iron stores and iron availability in patients with chronic kidney disease
Autor(s): M. Carta
Issue: RIMeL - IJLaM, Vol. 2, N. 1, 2006 (MAF Servizi srl ed.)
Page(s): 107-110
There is abundant evidence that treatment with erythropoiesis- stimulating (ESAs) leads to improved quality of life in patients with renal anaemia. This treatment increases the need for iron as it stimulates the synthesis of new red cells. Adequate iron availability increases erythropoiesis and reduces ESAs requirements. The laboratory ought to assess iron availability and iron stores but this is very difficult in this patients. Serum ferritin is the standard test used to assess iron stores but ferritin acts as a positive acute-phase reactant and serum levels may be increased without any changes to body iron stores. The availability of iron is determined by percentage of transferrin saturated with iron but it is associated with high day to day variation. Furthermore the concentration of transferrin varies during acute and chronic inflammatory reactions. The availability of iron should be assessed by measuring the percentage of hypochromic red blood cells or by reticulocyte haemoglobin content.