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Iron indices in chronic kidney disease in the National Health and Nutritional Examination Survey 1988-2004.
Clin J Am Soc Nephrol. 2009 Jan; 4(1):57-61.CJ

Abstract

BACKGROUND AND OBJECTIVES

Anemia is a common and early complication of nondialysis chronic kidney disease (CKD). One contributing factor is iron deficiency, which may be particularly problematic during erythropoietin replacement therapy. The aim of this study was to examine the prevalence of iron deficiency in nondialysis CKD.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

The National Health and Nutritional Examination Survey (NHANES) data for NHANES III (1988 to 1994) and subsequent NHANES 2-yr datasets, 1999 to 2000, 2001 to 2002, and 2003 to 2004 were analyzed for individuals >18 yr old.

RESULTS

It was found that low levels of iron tests [either serum ferritin < 100 ng/ml or transferrin saturation (TSAT) < 20%] were present in most patients with reduced creatinine clearance (CrCl). The percentage of low iron tests was higher among women than men, present in 57.8 to 58.8% of men and 69.9 to 72.8% of women (P < 0.001). With declining levels of CrCl, in women, TSAT levels decreased, whereas, surprisingly, serum ferritin tended to progressively increase. The percentage of anemic subjects increased progressively with declining quartiles of TSAT but was unrelated to serum ferritin quartiles.

CONCLUSIONS

It was found that low levels of iron tests, following National Kidney Foundation/Kidney Disease Outcomes Quality Initiative guidelines (either serum ferritin < 100 ng/ml or TSAT < 20%) were present in most patients with reduced CrCl.

Authors+Show Affiliations

Winthrop University Hospital, Mineola, NY 11501, USA. sfishbane@metrorenal.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18987297

Citation

Fishbane, Steven, et al. "Iron Indices in Chronic Kidney Disease in the National Health and Nutritional Examination Survey 1988-2004." Clinical Journal of the American Society of Nephrology : CJASN, vol. 4, no. 1, 2009, pp. 57-61.
Fishbane S, Pollack S, Feldman HI, et al. Iron indices in chronic kidney disease in the National Health and Nutritional Examination Survey 1988-2004. Clin J Am Soc Nephrol. 2009;4(1):57-61.
Fishbane, S., Pollack, S., Feldman, H. I., & Joffe, M. M. (2009). Iron indices in chronic kidney disease in the National Health and Nutritional Examination Survey 1988-2004. Clinical Journal of the American Society of Nephrology : CJASN, 4(1), 57-61. https://doi.org/10.2215/CJN.01670408
Fishbane S, et al. Iron Indices in Chronic Kidney Disease in the National Health and Nutritional Examination Survey 1988-2004. Clin J Am Soc Nephrol. 2009;4(1):57-61. PubMed PMID: 18987297.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Iron indices in chronic kidney disease in the National Health and Nutritional Examination Survey 1988-2004. AU - Fishbane,Steven, AU - Pollack,Simcha, AU - Feldman,Harold I, AU - Joffe,Marshall M, Y1 - 2008/11/05/ PY - 2008/11/7/pubmed PY - 2009/4/11/medline PY - 2008/11/7/entrez SP - 57 EP - 61 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 4 IS - 1 N2 - BACKGROUND AND OBJECTIVES: Anemia is a common and early complication of nondialysis chronic kidney disease (CKD). One contributing factor is iron deficiency, which may be particularly problematic during erythropoietin replacement therapy. The aim of this study was to examine the prevalence of iron deficiency in nondialysis CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The National Health and Nutritional Examination Survey (NHANES) data for NHANES III (1988 to 1994) and subsequent NHANES 2-yr datasets, 1999 to 2000, 2001 to 2002, and 2003 to 2004 were analyzed for individuals >18 yr old. RESULTS: It was found that low levels of iron tests [either serum ferritin < 100 ng/ml or transferrin saturation (TSAT) < 20%] were present in most patients with reduced creatinine clearance (CrCl). The percentage of low iron tests was higher among women than men, present in 57.8 to 58.8% of men and 69.9 to 72.8% of women (P < 0.001). With declining levels of CrCl, in women, TSAT levels decreased, whereas, surprisingly, serum ferritin tended to progressively increase. The percentage of anemic subjects increased progressively with declining quartiles of TSAT but was unrelated to serum ferritin quartiles. CONCLUSIONS: It was found that low levels of iron tests, following National Kidney Foundation/Kidney Disease Outcomes Quality Initiative guidelines (either serum ferritin < 100 ng/ml or TSAT < 20%) were present in most patients with reduced CrCl. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/18987297/Iron_indices_in_chronic_kidney_disease_in_the_National_Health_and_Nutritional_Examination_Survey_1988_2004_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=18987297 DB - PRIME DP - Unbound Medicine ER -