Background and Objectives. There is no data analyzing the outcome of
blood transfusions and oral
iron therapy in patients with kidneys failure in sub-Saharan Africa. The present study aimed to fill that gap and assess the value of
ferritin in the diagnosis of
iron overload and deficiency. Design. From January to February 2012, we prospectively studied 85
hemodialysis patients (78% of males and 22% of females aged 20 to 79 years) attending the Gabonese National
Hemodialysis Centre. Results. Correlation studies showed (a) a strong positive linear relationship between the number of
blood transfusions and high serum
ferritin in
hemodialysis patient (Spearman r : 0.74; P value: 0.0001); (b) a weak association between the number of
blood transfusions and serum
iron concentrations (Spearman r : 0.32; P value: 0.04); (c) a weak association between serum
ferritin and serum
iron (Spearman r : 0.32; P value: 0.003). Also, the strength of agreement beyond chance between the levels of
ferritin and
iron in the serum was poor (κ = 0.14). The prevalence of
iron overload was 10.6%, whereas the prevalence of
iron deficiency was 2.3%, comparing (1) patients with a maximum of one transfusion not on
iron therapy; (2) patients with a maximum of one transfusion on
iron therapy; (3) polytransfused patients not on
iron therapy; and (4) polytransfused patients on oral
iron therapy. The "Kruskal-Wallis test" showed that
ferritin levels varied significantly between the groups (P value: 0.0001). Conclusion. Serum
ferritin is not reliable as a marker of
iron overload. For patients undergoing regular transfusion we recommend routine serum
ferritin measurement and yearly measurement of LIC.