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Transferrin receptor assay and zinc protoporphyrin as markers of iron-deficient erythropoiesis in end-stage renal disease patients.
Clin Nephrol. 1998 Mar; 49(3):186-92.CN

Abstract

To evaluate storage iron deficiency and iron-deficient erythropoiesis we determined, in a cross-sectional study of 95 patients mainly including end-stage renal disease patients (ESRD) with (32) and without rh-EPO therapy (55), the following parameters: hemoglobin, mean corpuscular red cell volume, ferritin, transferrin saturation (TS), zinc protoporphyrin (ZPP) and soluble transferrin receptor (TfR). In the dialysis group the percentage of positive samples with each marker of tissue iron supply defined as TS < 20%, ZPP > 40 mumol/mol Heme and TfR > 3.05 microgram/ml was as follows: TS 43.7% and 32.2% at a diagnostic threshold level of < 16%, ZPP 33.3% and TfR 17.2%. Manifest storage iron deficiency defined as ferritin < 30 ng/ml was observed in 5.7% of the samples while the mean ferritin concentration of the rh-Epo treated dialysis patients was 509.3 ng/ml compared to 262.5 ng/ml in the group without rh-EPO therapy. These data reflect a generous iron substitution in our series taking a TS < 20% as an intervention criterion. Looking at the different results of the three markers the best correspondence was found between ZPP and TfR resulting in a weak positive correlation (+0.64). In conclusion, we found quite different results with different assays when evaluating endogenous iron availability in our series of mainly ESRD patients in a cross-sectional study. Because a gold-standard is not defined further firm conclusions cannot be drawn from this type of study. The adequacy of the different parameters of iron metabolism including threshold levels and, consequently, the decision and route of iron substitution deserve an evaluation in a longitudinal study to characterize the best marker or marker combination in this setting.

Authors+Show Affiliations

Baldus M
Medizinische Klinik A, Stadt Ludwigshafen am Rhein, Germany.
Walter H
No affiliation info available
Thies K
No affiliation info available
Anders C
No affiliation info available
Stein M
No affiliation info available
Hellstern P
No affiliation info available
Brass H
No affiliation info available

MeSH

AdultAgedAged, 80 and overAnemia, Iron-DeficiencyBiomarkersErythrocyte IndicesErythropoiesisErythropoietinFemaleFerritinsHemoglobinsHumansIronKidney Failure, ChronicMaleMiddle AgedProtoporphyrinsReceptors, TransferrinRecombinant ProteinsTransferrin

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9543601

Citation

Baldus, M, et al. "Transferrin Receptor Assay and Zinc Protoporphyrin as Markers of Iron-deficient Erythropoiesis in End-stage Renal Disease Patients." Clinical Nephrology, vol. 49, no. 3, 1998, pp. 186-92.
Baldus M, Walter H, Thies K, et al. Transferrin receptor assay and zinc protoporphyrin as markers of iron-deficient erythropoiesis in end-stage renal disease patients. Clin Nephrol. 1998;49(3):186-92.
Baldus, M., Walter, H., Thies, K., Anders, C., Stein, M., Hellstern, P., & Brass, H. (1998). Transferrin receptor assay and zinc protoporphyrin as markers of iron-deficient erythropoiesis in end-stage renal disease patients. Clinical Nephrology, 49(3), 186-92.
Baldus M, et al. Transferrin Receptor Assay and Zinc Protoporphyrin as Markers of Iron-deficient Erythropoiesis in End-stage Renal Disease Patients. Clin Nephrol. 1998;49(3):186-92. PubMed PMID: 9543601.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transferrin receptor assay and zinc protoporphyrin as markers of iron-deficient erythropoiesis in end-stage renal disease patients. AU - Baldus,M, AU - Walter,H, AU - Thies,K, AU - Anders,C, AU - Stein,M, AU - Hellstern,P, AU - Brass,H, PY - 1998/4/17/pubmed PY - 1998/4/17/medline PY - 1998/4/17/entrez SP - 186 EP - 92 JF - Clinical nephrology JO - Clin Nephrol VL - 49 IS - 3 N2 - To evaluate storage iron deficiency and iron-deficient erythropoiesis we determined, in a cross-sectional study of 95 patients mainly including end-stage renal disease patients (ESRD) with (32) and without rh-EPO therapy (55), the following parameters: hemoglobin, mean corpuscular red cell volume, ferritin, transferrin saturation (TS), zinc protoporphyrin (ZPP) and soluble transferrin receptor (TfR). In the dialysis group the percentage of positive samples with each marker of tissue iron supply defined as TS < 20%, ZPP > 40 mumol/mol Heme and TfR > 3.05 microgram/ml was as follows: TS 43.7% and 32.2% at a diagnostic threshold level of < 16%, ZPP 33.3% and TfR 17.2%. Manifest storage iron deficiency defined as ferritin < 30 ng/ml was observed in 5.7% of the samples while the mean ferritin concentration of the rh-Epo treated dialysis patients was 509.3 ng/ml compared to 262.5 ng/ml in the group without rh-EPO therapy. These data reflect a generous iron substitution in our series taking a TS < 20% as an intervention criterion. Looking at the different results of the three markers the best correspondence was found between ZPP and TfR resulting in a weak positive correlation (+0.64). In conclusion, we found quite different results with different assays when evaluating endogenous iron availability in our series of mainly ESRD patients in a cross-sectional study. Because a gold-standard is not defined further firm conclusions cannot be drawn from this type of study. The adequacy of the different parameters of iron metabolism including threshold levels and, consequently, the decision and route of iron substitution deserve an evaluation in a longitudinal study to characterize the best marker or marker combination in this setting. SN - 0301-0430 UR - https://www.unboundmedicine.com/medline/citation/9543601/Transferrin_receptor_assay_and_zinc_protoporphyrin_as_markers_of_iron_deficient_erythropoiesis_in_end_stage_renal_disease_patients_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -