IJCRR - vol 05 issue 21, November, 2013
DIAGNOSIS OF IRON DEFICIENCY OF CHRONIC KIDNEY DISEASE : VALIDITY OF IRON PARAMETERS, RETICULOCYTE HEMOGLOBIN CONTENT(CHR) AND HYPOCHROMIC RED CELLS IN INFLAMMATORY STATE
Author: Vidyashankar P., Alan F. Almeida, Niwruti K. Hase, Arun Halankar, Harinakshi Rai, Sadanand Bhusari
Introduction: Diagnosis of iron deficiency is difficult in presence of uraemia. The validity of these tests in the presence of inflammation has not been studied, and it formed the basis of this enquiry. Methods: On hundred and twenty two consecutive chronic kidney disease (CKD III, IV, V-non dialysis) patients were enrolled. Complete hemogram, iron studies, Reticulocyte hemoglobin content (CHr) and percent hypochromic red cells (%Hypo), high sensitive CRP (hs-CRP) levels were done. In the study group of 122 patients screened, 103 patients were found to be iron deficient by Kidney Dialysis Outcome Quality Initiative (KDOQI) criteria. In the iron deficient patients, intra venous iron (i.v iron sucrose 1000mg) was administered in divided doses followed by erythropoetin and the tests were repeated after 4 weeks of completing i.v iron therapy. If the rise in Hb> 1gm%, at the end of 4 weeks, the patient were grouped into responders (iron deficient subjects). The rest were grouped as non responders(Iron replete).The value of the tests, individually or in combination, was determined in the subgroups and categorized based on hs-CRP levels (<5mg/L). Results: Fifty eight of the 103 patients responded to i.v iron therapy (iron deficient).Varied sensitivity, specificity, and positive and negative predictive values were noted when tests were used individually or in combination to diagnose iron deficiency anemia. Conclusion: Iron studies are useful screening methods, but In the presence of inflammation, the combination of parameters with CHr and Hypochromic red cells add to specificity.
Keywords: Iron deficiency, iron studies, Reticulocyte hemoglobin content (CHr), Hypochromic red cells (Hypo %), Inflammation.
Vidyashankar P., Alan F. Almeida, Niwruti K. Hase, Arun Halankar, Harinakshi Rai, Sadanand Bhusari. DIAGNOSIS OF IRON DEFICIENCY OF CHRONIC KIDNEY DISEASE : VALIDITY OF IRON PARAMETERS, RETICULOCYTE HEMOGLOBIN CONTENT(CHR) AND HYPOCHROMIC RED CELLS IN INFLAMMATORY STATE International Journal of Current Research and Review. vol 05 issue 21, November, 83-91
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