Urinary hemosiderin: role in evaluation of chronic venous insufficiency

  • Ashish Lal Shrestha Department of Vascular Surgery, the Christian Medical College, Vellore, India.
  • Indrani Sen Department of Vascular Surgery, the Christian Medical College, Vellore, India.
  • Edwin Stephen Department of Vascular Surgery, the Christian Medical College, Vellore, India.
  • Prabhu Premkumar Department of Vascular Surgery, the Christian Medical College, Vellore, India.
  • Sunil Agarwal | indiraagarwal@cmcvellore.ac.in Department of Vascular Surgery, the Christian Medical College, Vellore, India.
  • Sukesh Chandran Department of Transfusion medicine, the Christian Medical College, Vellore, India.

Abstract

Chronic venous insufficiency (CVI) leads to skin changes with dermal hemosiderin deposition. We studied the presence of hemosiderin in the urine to assess if this could be used as a biochemical marker for CVI. Hereby we present a case control study conducted in a tertiary care centre in South India. There were 100 cases with evidence of advanced CVI (the Clinical-Etiology-Anatomy-Pathophysiology classification: C5, C6) confirmed by duplex scanning. Controls were 50 patients with leg ulcers due to other etiologies. All patients were subjected to urinary hemosiderin testing. In all 100 patients with CVI (C5 and C6 disease) axial venous reflux was confirmed by duplex ultrasound. Superficial venous reflux was noted in 71% of patients and deep venous reflux in 54.%. Primary venous insufficiency was the etiology in 81% of patients. Only 4/100 patients had detectable amounts of hemosiderin in the urine. Urine hemosiderin testing to determine presence or absence of CVI yielded the following values: positive predictive value-80%; negative predictive value-33%; sensitivity-4% and specificity-98%. The test could not be recommended as a marker of CVI. In Indian patients urinary hemosiderin is not a useful screening test in CVI.

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Published
2012-08-13
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Original Articles
Keywords:
urinary haemosiderin, chronic venous insufficiency.
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How to Cite
Shrestha, A., Sen, I., Stephen, E., Premkumar, P., Agarwal, S., & Chandran, S. (2012). Urinary hemosiderin: role in evaluation of chronic venous insufficiency. Veins and Lymphatics, 1(1), e5. https://doi.org/10.4081/vl.2012.e5