es. Background Iron deficiency is common in children with kidney failure, but current guidelines are based on biomarkers of iron stores that may be influenced by inflammation. This is the first study that examined which serum iron indices were associated with stainable marrow iron stores (the gold standard) in this population with kidney failure who underwent bone biopsies. Methods This cross-sectional study enrolled 71 clinically stable children and young adults receiving dialysis who underwent bone biopsy for CKD-mineral bone disorder between 2007 and 2011. Bone biopsies were stained with Perls Prussian blue and independently interpreted by a pathologist blinded to participants' iron parameters and clinical status. Marrow staining was scored absent versus present to facilitate receiver operator curve (ROC) analysis. In ROC analysis, the ability of serum ferritin to detect stainable marrow iron stores was compared with that of transferrin saturation (TSAT), serum hepcidin, and clinical guideline-based iron deficiency cutoffs for serum iron, TSAT, and their combinations. Results The mean age was 17.2±4.4 years (range 2–28), and 30% of patients were female. Median dialysis vintage was 1.2 (interquartile range, 0.7–2.0) years, and 56% were supported by peritoneal dialysis. Mean hemoglobin was 12.4±1.7 g/dl, and 35% were receiving iron supplementation at the time of biopsy. On the basis of the gold standard of depleted marrow iron stores, 46.5% of patients were iron deficient. As an indicator of marrow iron staining, serum ferritin provided a larger area under the ROC curve than serum hepcidin, TSAT, or clinical guideline-based evaluation of TSAT+ferritin. Conclusions In this cohort of children and young adults with kidney failure, serum ferritin provided the best indication of stainable marrow iron stores, followed by TSAT....

中文翻译：

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利用血液生物标志物预测儿童骨髓铁储备


es.背景 缺铁在肾衰竭儿童中很常见，但目前的指南是基于可能受炎症影响的铁储存生物标志物。这是第一项研究，在接受骨活检的肾衰竭人群中，检查哪些血清铁指数与可染色的骨髓铁储存（金标准）相关。方法 这项横断面研究纳入了 71 名临床稳定的接受透析的儿童和年轻人，他们在 2007 年至 2011 年间因 CKD 矿物质性骨病接受了骨活检。骨活检采用普鲁士蓝染色，并由对参与者的铁不知情的病理学家独立解释。参数和临床状态。对不存在和存在的骨髓染色进行评分，以方便接受者操作曲线（ROC）分析。在 ROC 分析中，将血清铁蛋白检测可染色骨髓铁储备的能力与转铁蛋白饱和度 (TSAT)、血清铁调素以及基于临床指南的血清铁、TSAT 及其组合的缺铁临界值进行比较。结果 平均年龄为 17.2±4.4 岁（范围 2-28），30% 的患者为女性。中位透析年份为 1.2 年（四分位距，0.7-2.0）年，56% 的患者接受腹膜透析。平均血红蛋白为 12.4±1.7 g/dl，35% 在活检时正在接受铁补充剂。根据骨髓铁储备耗尽的金标准，46.5% 的患者缺铁。作为骨髓铁染色的指标，血清铁蛋白提供的 ROC 曲线下面积比血清铁调素、TSAT 或基于临床指南的 TSAT+铁蛋白评估更大。 结论 在患有肾衰竭的儿童和年轻人队列中，血清铁蛋白提供了可染色骨髓铁储存的最佳指示，其次是 TSAT。