TY - JOUR
T1 - Role of soluble transferrin receptor - An Iron marker in hemodialysis patients
AU - Yusra,
AU - Lismawati,
AU - Effendy, Devi
AU - Kurniawan, Linny
AU - Lydia, Aida
N1 - Publisher Copyright:
© 2022 Wolters Kluwer Medknow Publications. All rights reserved.
PY - 2022/11
Y1 - 2022/11
N2 - Background: Iron status assessment is crucial in end-stage renal disease hemodialysis (ESRD-HD) patients because iron deficiency may cause unresponsiveness to erythropoiesis-stimulating agent. Soluble transferrin receptor (sTfR) is a potential iron marker that is not influenced by inflammation, and the results among studies are still conflicting. This study evaluated the role of sTfR in determining iron deficiency in ESRD-HD patients. Methods: This cross-sectional study was conducted at the Hemodialysis Unit in Cipto Mangunkusumo Hospital, Indonesia, from August to September 2018 and included 127 ESRD-HD patients. The sTfR level, sTfR index (sTfR/log ferritin), iron status, ferritin level, and complete blood count were assessed. Transferrin saturation (TSAT) was used as a reference. The role of sTfR was analyzed using the Chi-square test and receiver operating characteristic curve analysis. Results: The median sTfR was 3.0 (range, 1.0-8.5) mg/l, and the median TSAT was 23% (4.0%-100%). The sTfR level in ESRD-HD patients with absolute iron deficiency was 3.9 (1.9-8.5) mg/l, in those with functional iron deficiency was 3.5 (1.9-5.4) mg/l, and in those with no iron deficiency was 2.6 (1.0-6.4) mg/l. The previous sTfR cut-off value of 2.5 mg/l had a sensitivity of 83.3%, specificity of 48.2%, positive predictive value (PPV) of 44.3%, and negative predictive value (NPV) of 85.4%, whereas the new sTfR cut-off value of 2.71 mg/l had a sensitivity of 83.3%, specificity of 56.5%, PPV of 48.6%, and NPV of 87.3%. TSAT and index TSAT were not influenced by inflammation. Conclusion: The cut-off sTfR value of 2.71 mg/l is better than 2.5 mg/l to determine the iron status in ESRD-HD patients.
AB - Background: Iron status assessment is crucial in end-stage renal disease hemodialysis (ESRD-HD) patients because iron deficiency may cause unresponsiveness to erythropoiesis-stimulating agent. Soluble transferrin receptor (sTfR) is a potential iron marker that is not influenced by inflammation, and the results among studies are still conflicting. This study evaluated the role of sTfR in determining iron deficiency in ESRD-HD patients. Methods: This cross-sectional study was conducted at the Hemodialysis Unit in Cipto Mangunkusumo Hospital, Indonesia, from August to September 2018 and included 127 ESRD-HD patients. The sTfR level, sTfR index (sTfR/log ferritin), iron status, ferritin level, and complete blood count were assessed. Transferrin saturation (TSAT) was used as a reference. The role of sTfR was analyzed using the Chi-square test and receiver operating characteristic curve analysis. Results: The median sTfR was 3.0 (range, 1.0-8.5) mg/l, and the median TSAT was 23% (4.0%-100%). The sTfR level in ESRD-HD patients with absolute iron deficiency was 3.9 (1.9-8.5) mg/l, in those with functional iron deficiency was 3.5 (1.9-5.4) mg/l, and in those with no iron deficiency was 2.6 (1.0-6.4) mg/l. The previous sTfR cut-off value of 2.5 mg/l had a sensitivity of 83.3%, specificity of 48.2%, positive predictive value (PPV) of 44.3%, and negative predictive value (NPV) of 85.4%, whereas the new sTfR cut-off value of 2.71 mg/l had a sensitivity of 83.3%, specificity of 56.5%, PPV of 48.6%, and NPV of 87.3%. TSAT and index TSAT were not influenced by inflammation. Conclusion: The cut-off sTfR value of 2.71 mg/l is better than 2.5 mg/l to determine the iron status in ESRD-HD patients.
KW - CKD
KW - hemodialysis
KW - inflammation
KW - iron
KW - transferrin receptor
UR - http://www.scopus.com/inward/record.url?scp=85145464456&partnerID=8YFLogxK
U2 - 10.4103/ijn.IJN_486_20
DO - 10.4103/ijn.IJN_486_20
M3 - Article
AN - SCOPUS:85145464456
SN - 0971-4065
VL - 32
SP - 555
EP - 559
JO - Indian Journal of Nephrology
JF - Indian Journal of Nephrology
IS - 6
ER -