d 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 chronic kidney disease-mineral bone disorder between 2007 through 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 vs. 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 cut-offs for serum iron, TSAT, and their combinations. Results: Mean age was 17.2 ± 4.4 years (range 2-28), and 30% of patients were female. Median dialysis vintage was 1.2 (IQR 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. Based on 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 higher area under the ROC curve than serum hepcidin, TSAT, or clinical guidelines-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 transferrin saturation. Copyright © 2024 by the American Society of Nephrology...

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

d 标准）在接受骨活检的肾功能衰竭人群中。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 年间因慢性肾病-矿物质性骨病接受了骨活检。骨活检采用 Perls 普鲁士蓝染色，并由盲法病理学家独立解读参与者的铁参数和临床状态。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。中位透析年限为 1.2 (IQR 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% 的患者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 曲线下面积高于血清铁调素、TSAT 或基于临床指南的 TSAT + 铁蛋白评估。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，其次是转铁蛋白饱和度。版权所有 © 2024 美国肾脏病学会...