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Assessing iron status: beyond serum ferritin and transferrin saturation.
Clin J Am Soc Nephrol. 2006 Sep; 1 Suppl 1:S4-8.CJ

Abstract

The increasing prevalence of multiple comorbidities among anemic patients with chronic kidney disease has made the use of serum ferritin and transferrin saturation more challenging in diagnosing iron deficiency. Because serum ferritin is an acute-phase reactant and because the inflammatory state may inhibit the mobilization of iron from reticuloendothelial stores, the scenario of patients with serum ferritin >800 ng/ml, suggesting iron overload, and transferrin saturation <20%, suggesting iron deficiency, has become more common. This article revisits the basis for the Kidney Disease Outcomes Quality Initiative recommendations regarding the use of serum ferritin and transferrin saturation in guiding iron therapy, then explores some of the newer alternative markers for iron status that may be useful when serum ferritin and transferrin saturation are insufficient. These newer tests include reticulocyte hemoglobin content, percentage of hypochromic red cells, and soluble transferrin receptor, all of which have shown some promise in limited studies. Finally, the role of hepcidin, a hepatic polypeptide, in the pathophysiology of iron mobilization is reviewed briefly.

Authors+Show Affiliations

University Hospitals of Cleveland and Department of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA. jaywish@earthlink.net

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17699374

Citation

Wish, Jay B.. "Assessing Iron Status: Beyond Serum Ferritin and Transferrin Saturation." Clinical Journal of the American Society of Nephrology : CJASN, vol. 1 Suppl 1, 2006, pp. S4-8.
Wish JB. Assessing iron status: beyond serum ferritin and transferrin saturation. Clin J Am Soc Nephrol. 2006;1 Suppl 1:S4-8.
Wish, J. B. (2006). Assessing iron status: beyond serum ferritin and transferrin saturation. Clinical Journal of the American Society of Nephrology : CJASN, 1 Suppl 1, S4-8.
Wish JB. Assessing Iron Status: Beyond Serum Ferritin and Transferrin Saturation. Clin J Am Soc Nephrol. 2006;1 Suppl 1:S4-8. PubMed PMID: 17699374.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessing iron status: beyond serum ferritin and transferrin saturation. A1 - Wish,Jay B, PY - 2007/9/19/pubmed PY - 2007/9/28/medline PY - 2007/9/19/entrez SP - S4 EP - 8 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 1 Suppl 1 N2 - The increasing prevalence of multiple comorbidities among anemic patients with chronic kidney disease has made the use of serum ferritin and transferrin saturation more challenging in diagnosing iron deficiency. Because serum ferritin is an acute-phase reactant and because the inflammatory state may inhibit the mobilization of iron from reticuloendothelial stores, the scenario of patients with serum ferritin >800 ng/ml, suggesting iron overload, and transferrin saturation <20%, suggesting iron deficiency, has become more common. This article revisits the basis for the Kidney Disease Outcomes Quality Initiative recommendations regarding the use of serum ferritin and transferrin saturation in guiding iron therapy, then explores some of the newer alternative markers for iron status that may be useful when serum ferritin and transferrin saturation are insufficient. These newer tests include reticulocyte hemoglobin content, percentage of hypochromic red cells, and soluble transferrin receptor, all of which have shown some promise in limited studies. Finally, the role of hepcidin, a hepatic polypeptide, in the pathophysiology of iron mobilization is reviewed briefly. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/17699374/Assessing_iron_status:_beyond_serum_ferritin_and_transferrin_saturation_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=17699374 DB - PRIME DP - Unbound Medicine ER -