Iron Status in Patients with Pre-dialysis Chronic Kidney Disease in a Tertiary Hospital in North-central Nigeria

Abstract

Anaemia in CKD is associated with poor quality of life and cardiovascular disease. Iron deficiency anaemia contributes to the anaemia burden in patients with CKD but studies on iron status in patients with non-dialysis-dependent CKD in Nigeria are sparse. The aim of the study, therefore, is to determine the iron status of patients with CKD in a tertiary hospital in North-central Nigeria. We conducted a cross-sectional study on 130 patients with pre-dialysis CKD. We obtained data on the socio-demography, and aetiology of CKD. We assessed the complete blood count, serum ferritin, transferrin, iron, total iron binding capacity (TIBC), transferrin saturation (TSAT), and serum creatinine. CKD epidemiology collaboration (CKD-EPI) was used to estimate the glomerular filtration rate (eGFR). The mean age of the study participants was 55 ± 15 years with a male-to-female ratio of 2.3: 1. The mean haemoglobin was 9.8±2.2g/dl and was worse as eGFR declined. Iron deficiency anaemia was present in 27.7% of the patients (17.7% had functional iron deficiency while 10% had absolute iron deficiency). The median serum ferritin was 257.50 (102.75 – 465.00) ng/ml, serum transferrin 298.00 (216.00 – 343.25) mg/dl, serum iron was 21.85 (11.80 – 29.63) umol/l, TIBC 74.00 (54.00 – 84.65) umol/l, and TSAT of 32.55 (19.06 – 43.00) %. There was no significant association between Iron deficiency anaemia and age, or gender. Functional iron deficiency is the major contributor to iron deficiency anaemia in our patients with pre-dialysis CKD. An initial assessment of iron status is recommended for patients with CKD, to inform early treatment.