Indian Journal of Medical Biochemistry

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VOLUME 22 , ISSUE 2 ( July-December, 2018 ) > List of Articles

ORIGINAL ARTICLE

Serum Ferritin Levels in Patients of Chronic Kidney Disease on Hemodialysis: A Need to Redefine Cutoff for Iron/Erythropoietin Therapy

Meghana K Padwal, Annapurna V Raichurkar, Rajani R Melinkeri

Keywords : Chronic kidney disease, C-reactive protein, Ferritin, Hemodialysis, Inflammation, Iron/erythropoietin (EPO) therapy

Citation Information : Padwal MK, Raichurkar AV, Melinkeri RR. Serum Ferritin Levels in Patients of Chronic Kidney Disease on Hemodialysis: A Need to Redefine Cutoff for Iron/Erythropoietin Therapy. Indian J Med Biochem 2018; 22 (2):95-99.

DOI: 10.5005/jp-journals-10054-0063

License: CC BY-NC 3.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Anemia is the common complication of chronic kidney disease (CKD) that mainly affects patients on hemodialysis therapy. The most precise tool to evaluate body iron stores is the measurement of serum ferritin levels. However, serum ferritin is also an acute phase reactant, and its levels may be influenced by inflammation. Objectives: (1) To measure serum ferritin and C-reactive protein (CRP) in the study group; (2) To correlate the levels of serum ferritin and CRP in patients on hemodialysis; (3) To establish a cutoff value for serum ferritin in patients of CKD on hemodialysis receiving Iron/EPO therapy. Materials and methods: The study participants (n = 240) were divided into three groups as group I: Total 80 cases of CKD on hemodialysis receiving iron/erythropoietin (EPO) therapy, Group II: Total 80 cases of CKD on hemodialysis not receiving iron/erythropoietin (EPO) therapy, and Group III: Age and gender-matched 80 healthy controls. Estimation of serum ferritin was done by automated chemiluminescent microparticle immunoassay (CMIA) and CRP by immunoturbidimetric technique. Results: We observed a statistically significant rise in serum ferritin Group I (1957.6 ± 714.1), Group II (1063.5 ± 478.6) as compared to Group III (101.21 ± 60.29) and CRP levels in group I (104.6 ± 70.8) as compared to group II(74.9 ± 55.8) and (3.7 ± 0.9) (p < 0.005).There is a significant positive correlation between ferritin and CRP (p < 0.005). Conclusion: High ferritin levels can be because of both increased iron stores and inflammation which may be associated with erythropoietin resistance, malnutrition, and increased mortality. A cutoff value of ferritin needs to be established for better interpretation.


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