Use of IV iron in iron deficiency anemia in CKD with raised serum ferritin
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 1274-1279
AbstractBackground: Many newer tests are now available to diagnose iron deficiency in CKD but these tests are not widely used in India as these tests are expensive and patients cannot afford these tests. Hence the traditional tests serum ferritin and transferrin saturation are needed to be studied more thoroughly to infuse IV iron to patients with iron deficiency anemia in CKD as many cannot afford ESAs and blood. Ferritin is an important indicator of iron overload as well as an acute phase reactant which increases in inflammatory conditions. Serum ferritin getting raised both in iron deficiency anemia and inflammatory states complicates our diagnosis. In this scenario TSAT plays important role in ruling out iron overload and inflammation is ruled out by inflammatory markers.
Objective: To study the effect of IV iron in patients with serum ferritin >1000ng/ml and TSAT <20%.
Methodology: This study was conducted at Department of Medicine, M.L.B. Medical College; Jhansi from March 2020 to November 2021, after seeking clearance from ethical committee and obtaining written informed consent from patient.
Result: It was seen than 18 patients showed improvement and had increase in Hb by 1g/dl. 1 patient had a reaction and transfusion was stopped immediately and 1 patient was lost to follow up.
Conclusion: Against the popular belief that infusion of iron in patients with raised serum ferritin should not be given, this study showed that after ruling out other causes of raised serum ferritin and iron overload by calculating TSAT, IV iron can be given to patients with raised serum ferritin as it shows improvement in anemia.
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