Kalantar-Zadeh K, Hofftken B, Wunsch H, Find H, Kleiner M, Luft FC
Diagnosis of iron deficiency anemia in renal failure patients in the post-erythropoietin era

Am J Kidney Dis (Aug) 26:292-299 1995

Bone marrow iron stores were assessed in a gemisch of renal failure patients (16 HD, 4 CAPD, 5 CRF of which 2 had allografts). 23 had received EPO. All had normochromic normocytic anemia with Hgb < 11.0 g/dl. Bone marrow iron stores (BMI) were rated 0-5+, with 5+ signifying overload, 3-4+ normal, 2+ relative iron deficiency, and 0-1+ definite iron deficiency. A serum ferritin <200 ng/ml was highly selective, in that it never occurred in patients with 3-4+ BMI stores. However, sensitivity was only 40-50%, reflecting frequent occurrence of high ferritins in patients with low BMI stores. TSAT < 20% had a high sensitivity (88-90%) and not very good selectivity (40-60%). Sensitivity of the TSAT increased to 100% and selectivity to 80% when patients with transferrin values <150 ng/dL (i.e., those with hypoproteinemia) were excluded. The results suggest that combining TSAT with ferritin, and excluding patients with low transferrin levels, is a good diagnostic approach. (Daugirdas)

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I am the main author of this article and was wondering, if I can review the feedbacks from others. Kamyar Kalantar-Zadeh, MD UCSF Divison of Nephrology
Kamyar Kalantar-Zadeh, MD (kalantar@pol.net)
San Francisco, CA USA-Sunday, August 31, 1997 at 00:43:10 (PDT)