Variability of ferritin measurements in chronic kidney disease; implications for iron management
Variability of ferritin measurements in chronic kidney disease; implications for iron management
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DOI：
10.1038/ki.2008.526
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发表时间：
2009-01-01
影响因子：
19.6
通讯作者：
Scott, Mitchell G.
中科院分区：
文献类型：
--
作者：
Ford, Bradley A.;Coyne, Daniel W.;Scott, Mitchell G.
血清铁蛋白水平是铁储存的替代指标;现有的血液透析患者贫血管理指南建议血清铁蛋白浓度应维持在> 200 ng/ml。KDOQI的建议进一步指出，当铁蛋白水平超过500 ng/ml时，没有足够的证据支持常规静脉注射铁剂。在这里，我们确定了长期血液透析患者血清铁蛋白测量的测定间差异和短期个体内变异性，以说明这些差异如何影响治疗决策。比较6种常用的铁蛋白测定法，发现方法间差异高达150 ng/ml，这些测定法评价了来自血液透析和非血液透析患者的13个血清池。在60例稳定的血液透析患者中，铁蛋白的个体内变异性在最初两周内测量为2-62%，在六周内测量为3-52%。我们的研究结果表明，单一的血清铁蛋白值不应用于指导临床决策的治疗慢性血液透析患者静脉铁剂由于显着的分析和个体内变异。
Serum ferritin levels are a proxy measure of iron stores; existing guidelines for managing anemia in hemodialysis patients suggest that serum ferritin concentrations should be maintained at > 200 ng/ml. The KDOQI recommendations further state there is insufficient evidence advocating routine intravenous iron when ferritin levels exceed 500 ng/ml. Here we determined the interassay differences and short-term intraindividual variability of serum ferritin measurements in patients on chronic hemodialysis to illustrate how these variances may affect treatment decisions. Intermethod variations of up to 150 ng/ml were found comparing six commonly used ferritin assays that evaluated thirteen pools of serum from hemodialysis and nonhemodialysis patients. The intraindividual variability for ferritin in 60 stable hemodialysis patients ranged between 2-62% measured over an initial two-week period and from 3-52% when factored over a six-week period. Our results suggests that single serum ferritin values should not be used to guide clinical decisions regarding treatment of chronic hemodialysis patients with intravenous iron due to significant analytical and intraindividual variability.