Sensitivity and Specificity of Transferrin Saturation and Serum Ferritin as Markers of Iron Status After Intravenous Iron Dextran in Hemodialysis Patients

Low, Chai L.; Bailie, George R.; Eisele, George

doi:10.3109/08860229709037218

Cited by 13 publications

(12 citation statements)

References 18 publications

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“…Also in pre-dialysis patients, and in patients on HD, therapy with iron dextran was able to increase Hb and ferritin levels [13,14,15]. The efficacy and benefit of iron dextran therapy in dialysis patients is also proven in patients with functional or absolute iron deficiency, and with different dosing patterns [16,17,18,19]. …”

Section: Discussionmentioning

confidence: 99%

Low-Molecular-Weight Iron Dextran in the Management of Renal Anaemia in Patients on Haemodialysis – the IDIRA Study

Rath

Florschütz²,

Kalb³

et al. 2009

Nephron Clin Pract

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Background: Intravenous iron supplementation is a basic principle in the therapy of haemodialysis (HD) patients with renal anaemia. In the Iron Dextran in Renal Anaemia (IDIRA) study, we analysed the efficacy of a therapy with low-molecular-weight iron dextran (LMW-ID) in stable HD patients with adequate iron stores previously treated with ferric gluconate. Methods: IDIRA was an open-label, prospective, non-randomized, observational multicenter trial over 12 months in iron-repleted HD patients. All patients were treated with intravenous LMW-ID. Measures of efficacy were changes of haemoglobin (Hb), serum ferritin, erythropoietin dose and the response to iron therapy calculated as ferritin efficacy and Hb efficacy. Statistical analysis was done by the Wilcoxon test. Results: A total of 221 HD patients with a mean age 63.7 ± 13.8 years were included. A total of 208 out of 221 patients were on erythropoietin therapy. Median time on dialysis was 2 (1–4) years. Mean Kt/V was 1.3. Of the 221 patients, 208 completed the 12-month study period. Mean Hb and serum ferritin increased without the need for higher erythropoietin doses. The mean amount of iron per week administered remained stable. Ferritin efficacy and Hb efficacy improved using LMW-ID (p < 0.01). Conclusions: We conclude that LMW-ID improves anaemia management even in iron-pretreated HD patients.

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Section: Discussionmentioning

confidence: 99%

Low-Molecular-Weight Iron Dextran in the Management of Renal Anaemia in Patients on Haemodialysis – the IDIRA Study

Rath

Florschütz²,

Kalb³

et al. 2009

Nephron Clin Pract

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“…82 The diagnostic value of serum ferritin, however, is limited by its behavior as a potent acute phase reactant. [118][119][120] Given the low sensitivity, a high or normal serum ferritin is not sufficient to exclude the possibility of iron deficiency. [118][119][120] Given the low sensitivity, a high or normal serum ferritin is not sufficient to exclude the possibility of iron deficiency.…”

Section: Monitoring a And D Diagnosis O Of I Iron D Deficiency In C Cmentioning

confidence: 99%

“…[118][119][120] As a result, low values of transferrin saturation cannot reliably make the diagnosis of iron deficiency in this patient population, and results are often falsely positive. K/DOQI™ guidelines recommend using a value of less than 20% as an indicator of iron deficiency in patients with CKD.…”

Section: Monitoring a And D Diagnosis O Of I Iron D Deficiency In C Cmentioning

confidence: 99%

Anemia in Chronic Kidney Disease

Fishbane¹,

Masani²

2005

Chronic Kidney Disease, Dialysis, &Amp; Transplantation

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“…Ferritin correlates well with iron stores in patients with or without ESRD. 15,40,41 In lieu of transferrin, the per centage of hypochromic RBCs greater than 5-10% can be used. 14,21,33 Two studies 42,43 suggested that ferritin is a use ful marker in cancer patients not receiving chemotherapy, but is not as plausible in those receiving chemotherapy.…”

Section: Iron Deficiency and Supplementationmentioning

confidence: 99%

Factors and Predictors of Response with Epoetin Alfa for Chemotherapy-Related Anemia

Goram¹

2000

Journal of Pharmacy Technology

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To describe the value of specific factors and predictors that influence the use of epoetin alfa for anemia in adults with cancer receiving chemotherapy with or without radiation therapy.Data Sources: Data search restricted to English-language literature on epoetin alfa identified by MEDLINE searches (1990-July 2000) and other pertinent literature was conducted.Data Synthesis: Anemia of chronic disease (ACD) is a common finding among cancer patients. Patients receiving repeated or multiple chemotherapy regimens alone or with radiation therapy may worsen ACD. Blood transfusion is the cornerstone of treatment. Risks associated with allogeneic blood transfusion are clearly established. This includes alteration of the immune system, acute allergic reactions, viral and bacterial infections, tumor reappearance, and reduced quality of life (QOL). As the demand for blood increased and periodic supply shortages occurred, healthcare centers began seeking alternatives to blood transfusion. Recombinant human erythropoietin (epoetin alfa) is a prophylactic or treatment option that can reduce the need for blood transfusion with an improved QOL. Albeit clinically beneficial, epoetin alfa is expensive. Using predictors during early use with epoetin alfa, clinicians can identify patients most likely and least likely to benefit from further therapy, thus preventing costly outcomes. The change in hemoglobin (>0.5-1.0 g/dL) combined with either endogenous erythropoietin concentration (<100 mU/mL) or absolute reticulocyte count increase (>40,000 cells/pL) two to four weeks after starting therapy provided the most powerful prediction of response to epoetin alfa.Conclusions: Key factors and predictors with epoetin alfa can optimize therapy outcomes in cancer patients receiving chemotherapy.

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Sensitivity and Specificity of Transferrin Saturation and Serum Ferritin as Markers of Iron Status After Intravenous Iron Dextran in Hemodialysis Patients

Abstract: This study was designed to investigate the effect of intravenous (i.v.) iron dextran (ID) on hematocrit (Hct), transferrin saturation (TS), and serum ferritin ( S F ) in hemodialysis patients treated with a constant dose of erythropoietin (EPO

Cited by 13 publications

References 18 publications

Low-Molecular-Weight Iron Dextran in the Management of Renal Anaemia in Patients on Haemodialysis – the IDIRA Study

Low-Molecular-Weight Iron Dextran in the Management of Renal Anaemia in Patients on Haemodialysis – the IDIRA Study

Anemia in Chronic Kidney Disease

Factors and Predictors of Response with Epoetin Alfa for Chemotherapy-Related Anemia

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