Clinical Trial: Out Come Study To Define Laboratory Parameters That Are Best Suited to Diagnose Functional Iron Deficiency

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Swiss Functional Iron Deficiency Study

Brief Summary: The purpose of the study is to define laboratory parameters which are best suited to diagnose functional iron deficiency. Functional iron deficiency is a condition where - due to the lack of iron bioavailability - the patient suffers from symptoms such as fatigue and weakness, or his/her capacity to produce red blood cells is reduced.

Detailed Summary:

In dialysis patients the degree of anemia is highly correlated to both morbidity and mortality. A drop in Hb by 10 g/L translates into an increase in the rate of hospitalizations of 5 to 6 % and a rise in mortality by 4 to 5 %. The past two decades have seen great progress in the treatment of renal anemia with the advent of erythropoietin, and, more recently, darbepoetin. Quite soon, however, it became clear, that anemia in patients with chronic renal failure is complicated by a lack of bioavailable iron, which confers these patients partly resistant to treatment with erythropoietin/darbepoetin.

There are several parameters in use to estimate total body iron stores in the diagnosis of iron deficiency and iron deficiency anemia. Serum iron represents only a minor fraction of total body iron and is subject to major fluctuations due to influx or efflux from tissue iron stores. In addition, it shows a great diurnal variability, and is therefore a very poor parameter of iron deficiency. Iron saturation of its transporter protein in blood, transferrin, is similarly difficult to interpret, as it depends also in part on the determination of serum iron levels. Ferritin, the tissue iron storage protein, is released into the circulation during active liver cell damage, and, quite unlike serum transferrin levels, ferritin levels rise during the acute phase response of the inflammatory reaction. In most cases, however, the serum ferritin level, if substantiated by the concurrent determination of the C-reactive protein and the alanine-leucine-aminotransferase (ALT) to exclude both, occult liver cell damage and inflammation, correlates well with total body iron stores and total body iron deficiency, respectively.

The serum ferritin level, however, is a poor marker of functional iron deficiency when erythropoiesis is inhibited by the rela
Sponsor: Spital Zollikerberg

Current Primary Outcome:

  • Change in Hemoglobin [ Time Frame: 12 months ]
  • Costs = erythropoietin/darbepoetin prescribed [ Time Frame: 12 months ]


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Changes in soluble transferrin receptor [ Time Frame: 12 months ]
  • Changes in transferrin saturation [ Time Frame: 12 months ]
  • changes in ferritin [ Time Frame: 12 months ]


Original Secondary Outcome: Same as current

Information By: Spital Zollikerberg

Dates:
Date Received: July 2, 2007
Date Started: October 2004
Date Completion:
Last Updated: July 2, 2007
Last Verified: July 2007