Desempenho das variáveis clínicas e impacto da suplementação de ferro na identificação/prevenção da deficiência de ferro em doadores de sangue total da Fundação Hemoam

Abstract

Iron deficiency is a public health challenge, as it is the leading cause of anemia worldwide, and blood donors are a susceptible group without an established prevention protocol. It mainly affects blood donors of childbearing age, causing a higher rate of unfitness and loss of donors. Objective: To evaluate the clinical variables and the impact of iron supplementation on the identification/prevention of iron deficiency in whole blood donors at the HEMOAM Foundation. Method: Randomized clinical trial carried out at the Amazonas Hematology and Hemotherapy Foundation. Able-bodied donos, aged 18 and over, were randomized into two supplementation groups, one with 40 mg of oral elemental iron on Mondays, Wednesdays and Fridays and the other weekly for 13 weeks. A third group was made up of donors who used less than 10% of the supplementation. Sociodemographic, clinical and laboratory variables were collected on the day the participants were recruited into the study and again after 90 days, when they were evaluated. Results: 400 of 413 recruits were analyzed, the average age was 32 years, 131 (32,8 %) had iron deficiency with serum ferritin ≤ 30 ng/mL, of which 39 (9,5 %) had ferritin below 15 ng/mL (complete absence of iron in stock). Deficiency was higher in younger donors, as well as in frequent donors, particularly those with 3 or more donations in the previous 2 years. After 90 days, 146 (35,4 %) donors returned for reevaluation. 118 (80,8 %) donors complied with iron supplementation and only 28,2 % reported minor side effects. All hematimetric markers increased in both supplementation protocols; however, only the iron-deficient group showed an increase of 3 ng/mL in serum ferritin. Donors who received less than 10 % supplementation had a drop of 30 ng/mL in serum ferritin and 2 donors developed iron deficiency. Conclusion: Iron deficiency is very common among HEMOAM blood donors, particularly among those who donate frequently. Iron supplementation was not enough to restore iron stores, although it did increase hemoglobin levels and prevent the deterioration of iron stores