Choukroun Gabriel, Kazes Isabelle, Dantal Jacques, Vabret Elsa, Couzi Lionel, Le Meur Yannick, Trochu Jean-Noël, Cacoub Patrice
Service de néphrologie, médecine interne, dialyse, transplantation, CHU Amiens-Picardie, 1, rond-point du Professeur-Christian-Cabrol, 80000 Amiens, France.
Service de néphrologie et de transplantation rénale, hôpital Maison Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France.
Nephrol Ther. 2022 Jun;18(3):195-201. doi: 10.1016/j.nephro.2021.12.003. Epub 2022 Feb 28.
Iron deficiency is common and associated with worse outcomes in patients with non-dialysis chronic kidney disease. We performed a national, multicentre, observational and transversal study to assess the prevalence of iron deficiency as well as current iron deficiency screening practices in this population.
A total of 25 nephrology centres in France participated in the study. All adult non-dialysis chronic kidney disease patients who met the inclusion (GFR>15mL/min/1.73m) and exclusion criteria and provided consent were systematically recruited over a 4-week inclusion period. Investigators were asked to perform a blood test (hemoglobin concentration, serum iron, serum ferritin and transferrin saturation) and to complete a questionnaire about their iron status monitoring practices. The primary objective was to assess the prevalence of iron deficiency (serum ferritin<100μg/L and/or transferrin saturation<20%). Secondary objectives were to evaluate the prevalence of absolute iron deficiency (serum ferritin<100μg/L and transferrin saturation<20%) and functional iron deficiency (serum ferritin≥100μg/L and transferrin saturation<20%), the prevalence of iron deficiency according to haemoglobin concentration and chronic kidney disease stage, the proportion of centres that perform routine evaluation of iron status and the number of patients receiving iron supplementation.
A total of 1211 patients with non-dialysis chronic kidney disease were included in the analysis. The overall prevalence of iron deficiency was 47.1%. The rates of absolute iron deficiency and functional iron deficiency and anaemia were 13.4% and 17.1%, respectively. Among the 25 participating centres, 12 reported routine assessment of iron status in non-dialysis chronic kidney disease patients.
In this observational study, a high prevalence of iron deficiency was observed among non-dialysis chronic kidney disease patients. Less than half of participating centres reported routine assessment of iron status.
缺铁很常见,并且与非透析慢性肾脏病患者的不良预后相关。我们开展了一项全国性、多中心、观察性横断面研究,以评估该人群中铁缺乏的患病率以及当前的缺铁筛查实践。
法国共有25个肾脏病中心参与了这项研究。在为期4周的纳入期内,系统招募了所有符合纳入标准(肾小球滤过率>15mL/min/1.73m²)和排除标准并签署知情同意书的成年非透析慢性肾脏病患者。研究人员被要求进行血液检查(血红蛋白浓度、血清铁、血清铁蛋白和转铁蛋白饱和度),并填写一份关于其铁状态监测实践的问卷。主要目的是评估缺铁(血清铁蛋白<100μg/L和/或转铁蛋白饱和度<20%)的患病率。次要目的是评估绝对缺铁(血清铁蛋白<100μg/L且转铁蛋白饱和度<20%)和功能性缺铁(血清铁蛋白≥100μg/L且转铁蛋白饱和度<20%)的患病率、根据血红蛋白浓度和慢性肾脏病分期的缺铁患病率、进行铁状态常规评估的中心比例以及接受铁补充治疗的患者数量。
共有1211例非透析慢性肾脏病患者纳入分析。缺铁的总体患病率为47.1%。绝对缺铁、功能性缺铁和贫血的发生率分别为13.4%和17.1%。在25个参与中心中,12个报告对非透析慢性肾脏病患者进行了铁状态的常规评估。
在这项观察性研究中,非透析慢性肾脏病患者中铁缺乏的患病率较高。不到一半的参与中心报告进行了铁状态的常规评估。