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Association between common iron store markers and hemoglobin in children with chronic kidney disease. Pediatr Nephrol 2012 Dec;27(12):2275-83

Date

07/28/2012

Pubmed ID

22836305

Pubmed Central ID

PMC3492507

DOI

10.1007/s00467-012-2266-x

Scopus ID

2-s2.0-84879303270 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

BACKGROUND: Serum ferritin and transferrin saturation (TSAT) are used to assess iron status in children with chronic kidney disease (CKD), but their sensitivity in identifying those at risk of lower hemoglobin (HGB) values is unclear.

METHODS: We assessed the association of iron status markers (ferritin, TSAT, and serum iron) with age- and gender-related HGB percentile in mild-to-moderate CKD in 304 children in the Chronic Kidney Disease in Children (CKiD) Study. Standardized HGB percentile values were examined by KDOQI-recommended ferritin (≥ 100 ng/ml) and TSAT (≥ 20 %) thresholds. Regression tree methods were used to identify iron status markers and clinical characteristics most associated with lower HGB percentiles.

RESULTS: The cohort was 62 % male, 23 % African American, and 12 % Hispanic, median age 12 years, and median HGB 12.9 g/dl. 34 % had low TSAT and 93 % low ferritin as defined by KDOQI. Distribution of HGB percentile values was lower in those with ferritin ≥ 100 ng/ml, while TSAT ≥ 20 % was associated with only modest increase in HGB percentile. In regression tree analysis, lower glomerular filtration rate (GFR), serum iron <50 μg/dl and ferritin ≥ 100 ng/ml were most strongly associated with lower HGB percentile.

CONCLUSIONS: The level of GFR was significantly associated with HGB. Higher serum ferritin was associated with lower HGB in this cohort. Low serum iron in the context of normal/increased ferritin and low HGB may be a useful indicator of iron-restricted erythropoiesis.

Author List

Atkinson MA, Pierce CB, Fadrowski JJ, Benador NM, White CT, Turman MA, Pan CG, Abraham AG, Warady BA, Furth SL

Author

Cynthia G. Pan MD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Biomarkers
Child
Female
Ferritins
Glomerular Filtration Rate
Hemoglobins
Humans
Iron
Male
Renal Insufficiency, Chronic
Transferrin