A STUDY OF SERUM FERRITIN AND TRANSFERRIN SATURATION IN PATIENTS WITH ANEMIA IN CHRONIC KIDNEY DISEASE

BACKGROUND: Chronic Kidney disease is an important and non-communicable disease that affects people throughout the world. Anemia affects 60-80% of patients with renal impairment, and common in both pre-dialysis and in patients maintained on dialysis leading to decreased cognitive function, exercise tolerance, cardiac morbidity and mortality totally reduces quality of life and additional risk factor for early death. Present study of measurement of serum ferritin and transferrin saturation helps in diagnosis of iron deficiency in these chronic kidney disease patients. METHODS: A prospective study was conducted between November-2009 and August 2011 in Krishna Rajendra Hospital attached to Mysore Medical College and Research Institute Mysore. In this study fifty cases of CKD with anemia were randomly selected. All patient data was collected through history, physical examination and laboratory investigation. RESULTS: In this study fifty cases of CKD were randomly selected for this prospective study. Among the fifty cases mean age was 56+ 9 years. Male patients 39(78%) and female patients 11(22%) by ratio 3.5: 1. Most common symptoms were facial puffiness (92%), followed by pedal oedema (84%), easy fatigability (70%) and decreased urine output (22%). Most common associated diseases were diabetes mellitus (74%), hypertension (70%), IHD (30%) and dyslipidemia (14%). Mean haemoglobin percentage was 8.9 gm%, 40 (80%) patients were moderately anaemic. Most common type of anaemia was normocytic normochromic anemia with 30 (60%) patients, followed by microcytic hypochromic anemia, in 15(30%) patients and normocytic hypochronic anemia 5 (10%) patients. Among the fifty cases mean blood urea was 158.8mg% and mean serum creatinine was 9.5mg%. Among 50 patients 13(26%) patients has S. Ferritin concentration less than 100 ug% and 10 (20%) were between 100-200 ug% and 27 (54%) patients had > 200ug%. Mean S. ferritin concentration was 185.5+ 28.58. Among 50 patients 22 (44%) patients has transferrin saturation level < 20ug followed by 28 (56%) patients had > 20 ug%. Mean + SD for transferrin saturation is 16.61 + 6.2. CONCLUSION: Measurement of serum ferritin and transferrin saturation is the primary investigation used in making diagnosis of iron deficiency anemia in chronic kidney disease patients. Most of the CKD patients showed iron deficiency anemia.