title: Investigation of iron deficiency in patients with congestive heart failure: A medical practice that requires greater attention.
abstract: BACKGROUND
  Iron deficiency in congestive heart failure (CHF), with or without concomitant anaemia, is associated with health-related quality of life, NYHA functional class, and exercise capacity. Prospective, randomised studies have demonstrated that correcting iron deficiency improves the quality of life and functional status of patients with CHF, including those who do not have anaemia.
  
  
  OBJECTIVE
  The aim of this study was to analyse how frequently these iron parameters are tested and thus determine the extent to which this quality improvement tool has been implemented in patients admitted with CHF.
  
  
  METHODS
  Retrospective observational study of patients from a university hospital diagnosed with CHF on admission between 01/01/2012 and 11/06/2013.
  
  
  RESULTS
  Iron parameters were tested in 39% (324) of the 824 patients analysed. There was no significant difference in age between the patients whose iron was tested and those whose iron was not tested, but the difference in terms of gender was significant (P=.007). Glomerular filtration rate and haemoglobin, were significantly lower in the group of patients whose iron was tested (P<.001). The proportion of patients with anaemia, renal failure or both was significantly higher in the group of patients who had iron tests (P<.001). Of the 324 patients whose iron parameters were tested, 164 (51%) had iron deficiency. There were no differences between patients with and without iron deficiency in terms of age or gender. The iron parameters in both groups, ferritin and transferrin saturation index were significantly lower among the patients with iron deficiency (P<.001). The glomerular filtration rate values were significantly lower in patients with no iron deficiency (P<.001). Significant differences were also observed between those with and without iron deficiency in the proportion of patients with renal failure (79 vs. 66%, respectively, P=.013), but not in terms of haemoglobin concentration.
  
  
  CONCLUSIONS
  Congestive heart failure is very frequently associated with anaemia, iron deficiency and renal failure. Despite the fact that correcting iron deficiency is known to improve symptoms, testing of iron parameters in patients admitted with CHF is not performed as often as it should be.
authors.affiliation: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España. Electronic address: belmarvega@outlook.es.
authors.forename: Lara
authors.initials: L
authors.lastname: Belmar Vega
authors.affiliation: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España.
authors.forename: Alm
authors.initials: A
authors.lastname: de Francisco
authors.affiliation: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España.
authors.forename: Zoila
authors.initials: Z
authors.lastname: Albines Fiestas
authors.affiliation: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España.
authors.forename: Mara
authors.initials: M
authors.lastname: Serrano Soto
authors.affiliation: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España.
authors.forename: María
authors.initials: M
authors.lastname: Kislikova
authors.affiliation: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Seras Mozas
authors.affiliation: Departamento de Análisis Clínicos, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España.
authors.forename: Mayte García
authors.initials: MG
authors.lastname: Unzueta
authors.affiliation: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España.
authors.forename: Manuel
authors.initials: M
authors.lastname: Arias Rodríguez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000209:etiology; D059347:Cardio-Renal Syndrome / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D006333:Heart Failure / Q000097:blood / Q000150:complications*; D006801:Humans; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008297:Male; D012189:Retrospective Studies; D017678:Sex Distribution; D014168:Transferrin / Q000032:analysis
chemical_list: D014168:Transferrin; D005293:Ferritins; D007501:Iron
keywords: Anaemia; Anemia; Calidad de vida relacionada con la salud; Cardiorenal syndrome; Congestive heart failure; Deficiencia de hierro; Exercise intolerance; Health-related quality of life; Insuficiencia cardiaca congestiva; Insuficiencia renal; Intolerancia al ejercicio; Iron deficiency; Renal failure; Síndrome cardio-renal