The Prevalence of Iron Deficiency Anemia in Chronic Renal Failure at Maharat Nakhon Ratchasima Hospital

Abstract

The purpose of this descriptive cross-sectional pilot study was to determine the prevalence of iron deficiency anemia in non-dialysed adult patients with chronic renal failure presenting to Maharat Nakhon Ratchasima Hospital from November, 1993 to January, 1994. Twenty-eight patients, 12 male (42.99%) and 16 female (57.1%), with chronic renal failure who had serum creatinine 4mg/dl were included in the study. History taking and physical examinations were done in all patients on arrival at the hospital. Laboratory investions including routine urine analysis, stool examination, CBC, Hb typing, BUN, serum creatinine and LFT were performed in all cases. Ultrasonogram of the kidneys were performed in 25 cases. Blood samples were also taken for special nutritional laboratory investigations including serum iron, vitamin B12, serum folate, red cell folate and TIBC. Bone marrow aspiration was performed in all patients for determination of iron storage, myeloid erythroid ratio. All patients were found to be anemic (Hb<12mg/dl for female and <13mg/dI for male). All patients except four (14.3%) had stainable marrow iron. Two (7.1% of all cases) of the four patients with no stainable iron were associated with iron deficiency anemai as shown  by low level of hemoglobin, MCV, serum iron, and high TIBC and no hemoglobinpathy. these results showed that the prevalence of anemia in Thai patients with chronic renal failure are 100% but only 7.14% of the patients had iron deficiency anemia. The incidence hemoglobinopathies in Thai patients with CRF are also high (Hb E 33.3%, thalassemia thait 40.7%). There was a significant negative correlation between the hematocrit or the hemoglobin concentrations and serum creatinine levels.