ISSN 2997-1036
International Journal of Hematology | Vol. 3, No. 7, July 2012 | pp. 49–56
DOI: 10.46882/2012/IJH/000031
Original Article
Title: Serum erythropoietin kinetics and iron status parameters in patients with chronic kidney disease anemia
Names of Authors: A. I. Ibrahim¹, C. D. Balogun², E. O. Ojo³
Authors’ Affiliations: ¹Department of Haematology, Ahmadu Bello University, Zaria, Nigeria; ²Department of Medicine and Nephrology, University of Ilorin, Ilorin, Nigeria; ³Department of Chemical Pathology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
Abstract: Anemia in chronic kidney disease is primarily attributed to impaired erythropoietin production, but functional iron deficiency often complicates management. This cross-sectional study evaluated serum erythropoietin levels, ferritin, and soluble transferrin receptor concentrations in 85 non-dialysis chronic kidney disease patients (stages 3 to 5). Serum erythropoietin was quantified using an enzyme-linked immunosorbent assay. Despite severe anemia (mean hemoglobin 7.8 ± 1.2 g/dl), the median serum erythropoietin level was 12.4 mIU/ml, reflecting an inappropriately blunted response relative to the degree of hypoxia. Functional iron deficiency, defined by a transferrin saturation below 20% and serum ferritin above 100 ng/ml, was identified in 41.2% (35 of 85) of the patients. Soluble transferrin receptor levels correlated inversely with hemoglobin (r = -0.45, P < 0.01) and served as a superior index of marrow iron demand compared to ferritin alone. These results indicate that blunted endogenous erythropoietin production and restricted iron utilization are co-dominant factors in renal anemia. Integrating soluble transferrin receptor assays into routine diagnostic panels allows for more accurate identification of functional iron deficits prior to initiating recombinant erythropoietin therapy.
Keywords: Chronic kidney disease, renal anemia, erythropoietin, ferritin, soluble transferrin receptor
Manuscript Timeline: Received: April 10, 2012; Revised: May 18, 2012; Accepted: June 05, 2012; Published: July 12, 2012