الفهرس 
Anemia in hemodialysis patientsOnly 14 pages are availabe for public view
Abstract
Anemia is a common and significant consequence in hemodialysis patients. The common reasons for anemia in these patients are decreased erythropoietin production by the kidney and iron deficiency anemia.
Diagnosis of iron deficiency is traditionally based on ferritin and other iron parameters which becomes difficult in end stage renal disease patients due to the inflammatory condition which affects these markers and masks the iron deficiency. Serum soluble transferrin receptor (sTfR) is able to be a reliable indicator for assessing iron status, as it is not affected by inflammatory procedures.
The aim of this study was to evaluate the usefulness of serum soluble transferrin receptors in iron deficiency anemia detection in comparison to the classic markers of iron status in prevalent hemodialysis patients.
This was a case-control study assessed sTfR in 80 prevalent ESRD patients on regular hemodialysis in 2 groups. group A (N=40): CRP >10 and group B (N=40):CRP <10 and apparently healthy 8 control subjects.
Statistical analysis of our results revealed the following findings:
No significant difference between the studied groups regarding age, sex, smoking, cause of ESRD and laboratory data except in associated co-morbidity the patients with CRP>10 were more diabetic than patient with CRP<10.
ROC curve of STFRs in prediction of iron deficiency anemia showed that the cut of point for STFRs in hemodialysis patients is 12.5 with sensitivity 88.75, specificity 100, PPV 100 and NPV 47.1.
The prevalence of STFRs in patients with CRP<10 was 85%, while in patients with CRP>10 was 92.5% with non significant statistical difference.
The comparison between the patients with CRP<10 and the patients with CRP <10 showed non significant statistically difference as regard Hb and classic marker of iron deficiency (s.iron, TIBC, TSAT) while patients with CRP>10 have higher level of STFRs in comparison to patient with CRP<10.
The comparison between patients with CRP<10, patients with CRP>10 and control as regard Hb and STFR shows significant statistically difference with P-value 0.0001 and 0.0001 respectively.
Post Hoc analysis as regard Hb show significant statistically difference when comparing the patients with CRP<10 with control and the patient with CRP>10 with control with P-value 0.0001 and 0.0001 respectively.
Post Hoc analysis as regard STFRs shows significant statistically difference when comparing the patients with CRP<10 with control, the patients with CRP>10 with control and the patients with CRP<10 with patients with CRP>10 with P-value 0.0001, 0.0001 and 0.0001 respectively.
The hemodialysis patients who have elevated STFRs have risk 1.22 times to have iron deficiency anemia if CRP <10 (odds ratio: 1.22) and 3.14 times if CRP>10 (odds ratio: 3.14).
Serum STFRs was negatively correlated with s.iron and Kt\v (r -0.372, P-value 0.018) and (r-0.416, p value 0.008) respectively in patients with CRP <10.
Conclusion
Serum soluble transferrin receptor is highly sensitive and specific marker for iron deficiency in hemodialysis patients especially in patients with high CRP level.