الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease (CKD) is a growing health problem. Several published studies emphasize that CKD is underdiagnosed and under treated.
Although renal anemia is a major complication of CKD patients, in the last fifteen years recombinant human erythropoietin (rHuEPO) therapy has allowed therapeutic manipulation of the anemia in dialyzed and nondialyzed chronic renal failure.
The examination of bone marrow aspirate, stained with Prussian blue stain, is still considered as the best method for evaluating iron status in patients with indeterminate laboratory findings.
Serum ferritin, which reflects the total amount of body iron stores, is a universally available and standardized measurement and is the most effective test to detect iron deficiency.
Reticulocyte hemoglobin equivalent (RET- HE) generated by some automated hematological analyzers has been recognized as a direct assessment of the incorporation of iron into erythrocyte Hb and an estimate of the recent functional availability of iron into the erythron
Absolute iron deficiency in CKD patients has been defined on the basis of TSAT and serum ferritin levels, whereas functional iron deficiency results when there is a need for a greater amount of iron to support erythropoiesis than can be supplied. Thus, the conventional methods of estimating iron stores such as serum ferritin and TSAT are inadequate to evaluate functional iron deficiency.
During the intense use of rHuEPO, the amount of iron immediately available for erythropoiesis often proves insufficient, even though whole body iron stores may not be significantly depleted. This phenomenon, called ‘functional iron deficiency’ may be present despite normal serum ferritin and transferrin saturation (TSAT) values
Reticulocyte hemoglobin equivalent (RET- He) generated by some automated hematological analyzers has been recognized a direct assessment of the incorporation of iron into erythrocyte Hb and an estimate of the recent functional availability of iron into the erythron.
This study was conducted on a number of 126 patients with chronic kidney disease classified into three groups as follow
group 1: 44 CKD patients without anemia (Hb <12 in male) (Hb >11 in female).
group 2: 40 CKD patients with absolute iron deficiency .anemia TSAT<20, Hb<10, Ferritin<200 .
group 3: 42 CKD patients with functional IDA. Hb <10 TSAT <20 Ferritin >200.
All participants will be subjected to:
1- Detailed medical history including age, sex residence, comorbidity and duration of CKD.
2- Full clinical examination.
3- investigations:
Routin investigations:
- CBC
- Renal function test (Creatinin & BUN)
Special investigation:
- RET-He
- Iron profile (serum iron, TSAT, Serum ferritin)