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Iron deficiency across chronic kidney disease stages: Is there a reverse gender pattern?

PloS one
January 1, 2018
Mabel Aoun et al. (5 authors)
Journal ArticleObservational StudyHuman StudyClinical
Study Details

Study Goal

The researchers aimed to investigate the prevalence of iron deficiency in non-dialysis chronic kidney disease patients receiving erythropoiesis-stimulating agents and compare the diagnostic criteria from two guidelines.

Results Summary

The study found that iron deficiency is highly prevalent (48-78%) in non-dialysis chronic kidney disease patients on erythropoiesis-stimulating agents, with higher rates when using KDIGO-based criteria. Women showed more iron deficiency in early stages, while men had deficiencies at advanced stages, indicating inadequate iron supplementation in anemia management.

Population

Non-dialysis chronic kidney disease patients (n=238) with eGFR <60 ml/min, predominantly female (61.8%), median age 71 years.

Effective Dosage

Not specified

Duration

5 months

Interactions

None mentioned

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
iron therapy
neutral
iron deficiency
non-dialysis chronic kidney disease patients on erythropoiesis-stimulating agents
48 to 78%
required
#1
KDIGO-based criteria
increase
proportion of patients found to require iron therapy
non-dialysis chronic kidney disease patients on erythropoiesis-stimulating agents
-
higher values when using
#2
-
neutral
inverse normal transformations of ferritin and TSAT
men and women
-
showed a reverse pattern
#3
-
increase
iron deficiency
women
-
more iron deficient
#4
iron supplementation
neutral
anemia
pre-dialysis patients
-
lack in effective
#5
Abstract

In non-dialysis chronic kidney disease patients, looking for iron deficiency is highly variable in practice and there is a great variability regarding the cutoffs used to treat iron deficiency. The aim of this study is to investigate the degree of iron deficiency in non-dialysis chronic kidney disease patients on erythropoiesis-stimulating agents. We included all non-dialysis chronic kidney disease patients that applied to the Lebanese Ministry of Public Health for erythropoiesis-stimulating agents' coverage during a 5-month period. Iron requirement was assessed based on two guidelines' target-to-treat cutoffs: 1-ferritin <100 ng/ml and/or TSAT < 20% (KDOQI 2006), 2- ferritin ≤500 ng/ml and TSAT ≤30% (KDIGO 2012). A total of 238 CKD patients were included over 5 months. All patients had a ferritin level in their record and 64% had an available TSAT. Median age was 71.0 (59.8-79.3) years and 61.8% were female. All had an eGFR<60 ml/min. The proportion of patients found to require iron therapy ranged between 48 and 78% with a trend towards higher values when using KDIGO-based criteria. Using ANCOVA test, inverse normal transformations of ferritin and TSAT showed a reverse pattern between men and women with women being more iron deficient in the early stage. Iron deficiency is highly prevalent in non-dialysis chronic kidney disease patients on erythropoiesis-stimulating agents' therapy. These findings reflect a lack in effective iron supplementation when managing anemia in pre-dialysis patients, especially in men at advanced stages. Renal societies should spread awareness about iron deficiency screening in those patients.

Medical Subject Headings (MeSH)
AdultAgedAged, 80 and overAnemia, Iron-DeficiencyFemaleFerritinsHematinicsHumansIronIron DeficienciesKidney Failure, ChronicLebanonMaleMiddle AgedRenal Insufficiency, ChronicSex FactorsYoung Adult
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality70/10
Citation Metrics
Total Citations9
Citations/Year1.3
Relative Citation Ratio0.49
NIH Percentile26.5%
Research Impact Scores
APT Score0.50
Weight Score1.85
Normalized Score0.60
Iron deficiency across chronic kidney disease stages: Is the... | Panacea Index