Anemia in Chronic Kidney Disease

Brunelli, Steven M.; Berns, Jeffrey S.

doi:10.1016/b978-1-4377-0987-2.00007-8

Cited by 1 publication

(4 citation statements)

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“…The first is that there is no reported gold standard for noninvasive evaluation of iron status in cats for diagnosis of iron deficiency. In human patients, measurement of bone marrow reticuloendothelial iron is the gold standard for assessing iron stores; however, healthy cats do not have visible iron stores in their bone marrow . Iron stores have been evaluated in the feline liver and spleen and historically feline liver biopsies have been evaluated to assess tissue iron levels; however, this is not a commonly performed diagnostic test because of its invasive nature .…”

Section: Discussionmentioning

confidence: 99%

“…The etiology of anemia in cats with CKD is likely multifactorial although the main mechanism is inadequate erythropoietin production by diseased kidneys. Another potential contributor is an absolute iron deficiency, which occurs secondary to reduced oral iron intake, decreased gastrointestinal absorption, or loss through gastrointestinal bleeding . Absolute iron deficiency is defined as a reduction in bone marrow reticuloendothelial iron and in human patients is suggested by a percent transferrin saturation (TSAT) <20% and a ferritin concentration <100 ng/mL …”

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confidence: 99%

“…A functional iron deficiency, which occurs when there is an inability to utilize otherwise adequate body iron stores for erythropoiesis, is another potential contributor to anemia in cats with CKD . This is generally manifested as low serum iron but increased available iron in the reticuloendothelial system and can occur because of the decreased erythropoietin production by diseased kidneys or secondary to inflammation .…”

mentioning

confidence: 99%

“…This is generally manifested as low serum iron but increased available iron in the reticuloendothelial system and can occur because of the decreased erythropoietin production by diseased kidneys or secondary to inflammation . In human patients, a functional iron deficiency is suspected when TSAT is <20% and ferritin levels are normal or >100 ng/mL . Chronic inflammation has been shown to play a role in the pathogenesis of anemia primarily mediated by the acute phase protein hepcidin .…”

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Iron Status of Cats with Chronic Kidney Disease

Gest

Langston

Eatroff³

2015

Veterinary Internal Medicne

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BackgroundIron deficiency is a proposed mechanism for the anemia that occurs in cats with chronic kidney disease (CKD). Minimal research investigating the iron status of these cats has been performed.ObjectiveTo compare indicators of iron status in cats with CKD versus healthy cats and cats with nonrenal illness (NRI). To compare indicators of iron status in anemic versus nonanemic cats with CKD.AnimalsThiry‐nine client or employee owned healthy cats, 40 cats with CKD and 34 cats with NRI included.MethodsExclusion criteria included prior iron or erythropoiesis stimulating agent administration, blood transfusion, or concurrent CKD and NRI. Complete blood counts, serum chemistries, serum iron concentrations, total iron binding capacity (TIBC), and ferritin concentrations were measured and percent transferrin saturation (TSAT) calculated on all cats. Data were analyzed using nonparametric statistical testing.ResultsNo statistically significant differences were detected among groups for iron concentration (P = .50), ferritin concentration (P = .47), or TSAT (P = .19). TIBC was significantly lower in CKD (median 262 μg/dL; IQR 233–302; range 165–488) versus healthy cats (median 316 μg/dL; IQR 272–345, range 196–464); (P = .0030). When comparing anemic (hemoglobin <9.5 g/dL) versus nonanemic cats with CKD, TSAT was significantly lower (P = .033) in anemic (median 20.2%; IQR 17.8–34.5; range 17.6–35.9) compared to nonanemic (median 29.0%; IQR 25.5–44.1; range 11.5–94.4). No statistically significant differences found for ferritin concentration (P = .94), iron concentration (P = .21) or TIBC (P = .97).Conclusions and Clinical ImportanceThese results indicate that an iron deficient state exists in anemic cats with CKD and is more likely functional rather than absolute.

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Section: Discussionmentioning

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