Red cell ferritin, a marker of iron deficiency in hemodialysis patients

Estimation of red cell ferritin (RCFer) may give a good indication of iron supply to the erythron and it may therefore be clinically useful for the detection of functional iron deficiency.In a cross-sectional study of hemodialysis patients on erythropoietin (EPO) therapy and regular oral iron we have compared the RCFer levels with conventional indicators of iron status. The patients studied, 19 female, 48 male, mean age 62 ± 3.6 years (range 20–83 years) were characterized by the following mean parameters: aluminum 1.24 ± 0.12 µmol/L, PTH 115.7 ± 39 pg/mL, vitamin B12 626 ± 71.2 ng/L, serum folate 18.8 ± 2.2 µg/L, and hemoglobin 9.8 ± 0.3 g/dL (range 7.3–12.4).The median serum ferritin (SF), RCFer, total iron binding capacity (TIBC), transferrin saturation (TS), and serum iron were 68 µg/L, 14.1 ag ferritin/red cell, 57 µmol/L, 20% and 11.5 µmol/L, respectively. Eleven patients had a reduced RCFer (< 7 ag ferritin/red cell), 5 had a SF of < 15 µg/L and 22 a TS of < 16%. The occurrence of functional iron d...