Evaluation of iron status in anemic pre-dialysis chronic kidney disease patients

Background: Data on iron status are generally less readily available in pre-dialysis chronic kidney disease (CKD) patients than in the hemodialysis population. In Nigeria, little is known about iron indices in patients with CKD. Aims: The aim of this study was to evaluate the iron status among anemic pre-dialysis patients with CKD. Patients and Methods: Using a cross-sectional study design, we evaluated serum ferritin and transferrin saturation (TSAT) among 63 pre-dialysis CKD patients with anemia attending our outpatient nephrology clinic. CKD was defined as a glomerular filtration rate less than 60 ml/min/1.73 m2 for 3 months or more, while anemia was defined as a hemoglobin concentration (Hb) less than 11 g/dl. Results: The mean age of the study participants was 52.5 +/- 12.7 years and 33 (52.4%) of the patients were females. The most common causes of CKD were hypertension (44.4%) and diabetic nephropathy (30.6%). The mean Hb, mean serum ferritin, and mean TSAT were 9.2 +/- 1.1 g/dl, 106.6 +/- 72.7 ng/ml, and 24.3% +/- 7.9%, respectively. There was no significant difference in median ferritin (91[interquartile range: 54-133] ng/ml versus 106 [interquartile range: 45-151; P=0.75) and mean TSAT (24.9 +/- 7.2 % versus 23.8 +/- 7.7 %; P=0.54) between male and female study participants; Half (50.8%) of the study participants had absolute iron deficiency (serum ferritin < 100 ng/ml) and 6.3% had functional iron deficiency (ferritin > 100 ng/ml and TSAT < 20%). Conclusion: Iron deficiency is common among anemic adult Nigerian pre-dialysis CKD patients. Results of iron studies should guide therapy when correcting anemia in these patients.