• Daniel Setiawan MD Departement of Internal Medicine, Faculty of Medicine, Maranatha Christian University, Indonesia




Chronic Kidney Disease, Hemodialysis, Iron Status


Decreased of haemoglobin (Hb) in patients with CKD almost occurs in 80% of cases. The causes are multifactorial, including deficiency of erythropoietin production, a circulating factor that appears to inhibit erythropoietin, shortened red blood cell half-life, increased gastrointestinal blood loss due to thrombocytopenia, folic acid and iron deficiency, and blood loss from hemodialysis or laboratory test samples. This literature evaluation drew its data from full-text English publications published in the preceding up to 2000 until 2022. This study discusses iron status in CKD stage 5 patients undergoing regular hemodialysis. We utilised the databases Sage Pub, Pubmed, and Google Schoolar to create this study. Research shows that serum iron and TIBC levels of patients with CKD who undergo maintenance hemodialysis are better than CKD patients without hemodialysis, but lower than healthy controls and those who undergo kidney transplantation. This figure is different for ferritin.


Fauci AS, Jameson JL, Kasper D, et al. Harrison’s Principles of Internal Medicine 19th Edition. New York: McGraw-Hill Education; 2018.

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. New York; 2013.

Hallan SI, Matsushita K, Sang Y, et al. Age and association of kidney measures with mortality and end-stage renal disease. JAMA. 2012;7(2):2349–60.

Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar. Jakarta; 2018.

Aru W; Idrus A; Marcelus S; et al, S S, I A, AW S, Simadibrata M, Setiyohadi B, et al. Buku Ajar Ilmu Penyakit Dalam. 5 ed. Soeroso J, Isbagio H, Kalim H, Broto R, Pramudiyo R, editor. Jakarta: Interna; 2013. 3199–211 hal.

Piggiali E, Amicis MD, Motta I. Anemia of chronic disease: a unique defect of iron recycling for many different chronic diseases. Eur J Intern Med. 2014;25(1):12–7.

Weiss G; Goodnough L. Anemia of Chronic Disease. N Engl J Med. 2005;352(10):1011–23.

Agarwal N, Prchal JT. Anemia of Chronic Disease (Anemia of Inflammation). Karger Publ. 2009;122(2–3):78–82.

Stauffer ME, Fan T. Prevalence of anemia in chronic kidney disease in the United States. PLoS One. 2014;9(1):e84943.

Batchelor EK, Kapitsinou P, Pergola PE, Kovesdy CP, Jalal DI. Iron Deficiency in Chronic Kidney Disease: Updates on Pathophysiology, Diagnosis, and Treatment. J Am Soc Nephrol. 1 Maret 2020;31(3):456 LP – 468.

Urrechaga E, Borque L, Escanero J. Assessing Iron Status in CKD Patients: New Laboratory Parameters. In 2012. hal. 225–50.

Kovesdy CP, Estrada W, Ahmadzadeh S, Kalantar-Zadeh K. Association of markers of iron stores with outcomes in patients with nondialysis-dependent chronic kidney disease. Clin J Am Soc Nephrol. Februari 2009;4(2):435–41.

Rafi A, Karkar A, Abdelrahman M. Monitoring Iron status in End-Stage Renal Disease Patients on Hemodialysis. Saudi J Kidney Dis Transplant. 1 Januari 2007;18(1):73–8.

Malyszko J, Malyszko JS, Pawlak K, Mysliwiec M. Hepcidin, iron status, and renal function in chronic renal failure, kidney transplantation, and hemodialysis. Am J Hematol. 1 November 2006;81(11):832–7.

Rambod M, Kovesdy CP, Kalantar-Zadeh K. Combined High Serum Ferritin and Low Iron Saturation in Hemodialysis Patients: The Role of Inflammation. Clin J Am Soc Nephrol. 1 November 2008;3(6):1691 LP – 1701.

Ali TM, Genina AM, Abo-Salem OM. The determinants of hepcidin level in chronic kidney disease and hemodialysis Saudi patients. Beni-Suef Univ J Basic Appl Sci. 2014;3(2):133–9.

Iyawe I, Adejumo O, Iyawe L, Oviasu E. Assessment of iron status in predialysis chronic kidney disease patients in a Nigerian Tertiary Hospital. Saudi J Kidney Dis Transplant. 1 Desember 2018;29(6):1431–40.

Tsukamoto T, Matsubara T, Akashi Y, Kondo M, Yanagita M. Annual Iron Loss Associated with Hemodialysis. Am J Nephrol. 2016;43(1):32–8.

Ford BA, Coyne DW, Eby CS, Scott MG. Variability of ferritin measurements in chronic kidney disease; implications for iron management. Kidney Int. 2009;75(1):104–10.

Bhandari S, Allgar V, Lamplugh A, Macdougall I, Kalra PA. A multicentre prospective double blinded randomised controlled trial of intravenous iron (ferric Derisomaltose (FDI)) in Iron deficient but not anaemic patients with chronic kidney disease on functional status. BMC Nephrol. Maret 2021;22(1):115.

Soman A, Adiga U. Unbound Iron Binding Capacity (UIBC) – An Alternative Lab Parameter for Iron Stores? Int J Biochem Res Rev. 14 Juni 2018;22:1–7.

Raoof IB, Abdalah ME. Quality assessment of unsaturated iron-binding protein capacity in Iraqi patients undergoing hemodialysis. J Pharm Bioallied Sci. 2020;12(3):246–51.