1996 Volume 29 Issue 10 Pages 1379-1386
In this study, the serum transferrin receptor (sTfR) values in patients on chronic hemodialysis were obtained and their usefulness as an index of iron metabolism was studied by making comparisons with other iron parameters.
Serum Fe (sFe), serum ferritin (sFt), and sTfR levels in 207 patients on chronic hemodialysis were measured, and iron was then supplemented orally or intravenously in 146 patients suspected of having an iron deficiency. The correlations between the change in Ht values 8 weeks after the onset of iron supplementation (ΔHt) and the iron parameters before the administration of the iron were investigated. Furthermore, the Ht value, sFe, sFt, sTfR, Tf, sFe/Tf, and reticulocyte counts were obtained in 34 iron supplemented cases during the course of the study.
In all subjects, the following significant correlations were recognized; sTfR vs sFe (R=-0.289, p<0.0001), sTfR vs sFt (R=-0.244, p<0.0005), sFe vs sFt (R=0.240, p<0.0005). The correlations between ΔHt in the cases receiving iron supplementation and pre-administration parameters were as follows; sTfR (R=0.428, p<0.0001), sFe (R=-0.224, p<0.01, NS), sFt (R=-0.037, NS). The sTfR value showed the most significant correlation, while the sFt value did not show a definite correlation. Among 34 cases observed over the course of the study, pre-Tf showed a positive correlation with ΔHt (R=0.412, p<0.05). However, as compared with pre-sTfR (R=0.471, p<0.005) this correlation was minimal, and pre-sFe/Tf showed no correlations with ΔHt (R=0.233, NS). The changes in sFe, sFt, Tf, and sFe/Tf values showed the same trend as in non-uremic patients with iron deficiency anemia. The sTfR value showed no significant change after 4 weeks, though adecrease was evident after 8 weeks.
In patients on chronic hemodialysis, the sTfR value correlated positively with the correction of anemia after the administration of iron, as compared with other iron parameters. We conclude that the sTfR value is potentially a highly reliable parameter for assessing the status of iron deficiency.
