Korean Journal of Nephrology 1988;7(1):108-115.

혈액투석환자에서 골수내 철저장지표로서 혈청 Ferritin치의 의의

이원석 , 박성배 , 김현철 , 전동석

Abstract

Forty-five patients on maintenance hemodialysis un- derwent bone marrow aspirations for evaluation to iron stores that were to be compared to various hematologic parameters and clinical settings. Of the 45 patients, 20 (44.4%) had normal bone marrow iron stores and 25 (55. 6%) had increased iron stores. None of the patients had decreased iron stores in this study. Serum ferrtin, trans- ferrin saturation, serum iron, transfusion requirement were significantly higher in patients with increased iron stores, but there was no difference in MCV, iron binding capacity, duration of hemodialysis, and amount of orally administered iron between two groups with nor- mal and incresed bone marrow iron stores. The serum ferritin had the highest degree of positive correlation with bone marrow iron stores (r = 0.72, P < 0. 001), and there was also a significant correlation between bone marrow iron stores and transferrin saturation (r=0.53, P<0.001), serum iron (r=0.41, P<0. 01), but no correlation with the MCV and iron binding capacity. There was a significant correlation between bone marrow iron stores and total number of transfu- sion, but no correlation with orally administered iron and duration of hemodialysis. Transferrin saturation, serum iron, total number of transfusions were significanlty higher in patients with increased serum ferritin level, bu there was no significant difference in MCV, hematocrit, amount of orally administered iron, and duration of hemodialysis between 2 groups with normal and increased serum ferritin level. It is concluded that serum ferritin concentration appears to be a reliable indicator of stainable bone marrow iron stores in chronic hemodialysis patients. Regular monitoring of serum ferritin is necessary in these patients in order to iron treatment so that iron defi- ciency or iron overload can be avoided.