Cavill, "Guideline for the laboratory diagnosis of functional iron deficiency
," British Journal of Haematology, vol.
Most of the CKD patients showed absolute and functional iron deficiency
These reticulocyte changes will prevent the identification of functional iron deficiency
based on reduced CHr.
In their report, Thomas and Thomas (1) approach the diagnosis of ACD and functional iron deficiency
by determining two hematologic gold standard factors for iron deficiency: the presence of hypochromic erythrocytes (HYPO) and a reduced hemoglobin content of reticulocytes (CHr).
Be able to differentiate among absolute iron deficiency, functional iron deficiency
, and reticuloendothelial (RE) blockade.
Reticulocyte hemoglobin content predicts functional iron deficiency
in hemodialysis patients receiving rHuEPO.
In addition, IV iron can correct absolute iron deficiency (in which the body lacks sufficient iron stores) and functional iron deficiency
(in which EPO-induced erythropoiesis consumes circulating iron faster than the body can release stored iron) (K/DOQI, 2001).
The poor diagnostic accuracy of sTfR may be attributable to an adequate iron supply for erythropoiesis provided by circulating iron (absorbed from the intestine or recycled from senescent red cells) even without iron stores (11), or functional iron deficiency
even with adequate iron stores (12).
It is important for the nephrology nurse to understand the differentiating features between functional iron deficiency
and RE blockade because a diagnosis of these conditions cannot be based solely on laboratory parameters (see Table 4).
The ratio of transferrin receptor to ferritin displays an inverse linear relationship to iron status, covering the spectrum from usual iron stores in health to substantial functional iron deficiency
Neutrophil impairment associated with iron therapy in hemodialysis patients with functional iron deficiency
. Journal of the American Society of Nephrology, 9, 655-663.
Functional iron deficiency
. During rHuEPO therapy, a super-physiologic rate of erythropoiesis may cause iron demand to exceed supply, even in the presence of "adequate" iron stores.