Regulation of iron therapy by S-ferritin estimations in patients on chronic hemodialysis.

Serum ferritin estimation was compared with bone marrow hemosiderin staining in the primary diagnosis of iron deficiency and overload in 19 patients on chronic hemodialysis. Serum ferritin estimation had a high predictive value: all 8 patients with marrow iron grade III had elevated S-ferritin values, and 3 out of 5 iron-deficient patients had subnormal values, the other 2 low-normal values. Serum iron and transferrin estimation was of very little value. Prophylactic treatment with 100 mg iron sulphate daily p.o. was inadequate for 13 of the 19 patients: 8 had iron overload. 5 had iron deficiency. Iron sulphate therapy was monitored by bone marrow hemosiderin and serum ferritin values and 15 patients could be followed up for one year. It was shown that serum ferritin estimations could be used to monitor the iron therapy.