Serum ferritin compared with other indices of iron status in children and teenagers undergoing maintenance hemodialysis.

To determine how best to assess iron status, I studied 12 young renal patients (ages 5.5 to 20 years) undergoing regular hemodialysis treatments. Iron balance was estimated by monitoring iron loss ascribable to blood loss during dialysis and diagnostic testing, and iron intake in the form of oral and intravenous iron supplements and blood transfusions. Traditional methods of evaluating iron status--measurement of hemoglobin, erythrocyte indices, reticulocyte count, iron, and transferrin--were compared with measurement of serum ferritin. The serum ferritin measurements provided superior information. In three cases this method was superior to visual assessment of bone marrow stained for iron.