Iranian Journal of Pathology

Assessment of Urinary Ferritin as a Non-Invasive Diagnostic Test for Iron Deficiency Anemia in Pediatric Populations: A Case-Control Study

Document Type : Original Research

Authors

Hossein Esfahani 1
Arya Derakhshesh 2
Ali Reza Soltanian 3
Hassan Bazmamoun 4
Alireza Rastgoo Haghi 5

1 Department of Pediatric Hematology/Oncology, Hamadan University of Medical Science, Hamadan, Iran

2 Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran

3 Department of Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran

4 Department of Pediatric Gastroenterology, Hamadan University of Medical Sciences, Hamadan, Iran

5 Department of Pathology, Hamadan University of Medical Science, Hamadan, Iran

https://doi.org/10.30699/ijp.2025.2049356.3395
Abstract
Background & Objective: Iron deficiency anemia is the most prevalent form of anemia worldwide and can cause complications in children and adolescents. This study investigates the correlation between serum and urinary ferritin and evaluates the feasibility of using urinary ferritin to diagnose iron deficiency.
Methods: In this case-control study, 45 patients with iron deficiency anemia were included in the case group and 45 healthy children in the control group. From each participant, 1.5 mL of blood and 5 mL of urine were collected, and serum and urinary ferritin levels were measured using the chemiluminescent immunoassay (CLIA) method with Mindray kits. The results were analyzed and compared using SPSS software, version 16 (IBM Corp).
Results: The mean age of patients was 7.95 years, and that of controls was 7.26 years. Female patients constituted 62.2% of the case group, and female controls represented 46.7% of the control group. In patients, the mean serum ferritin level was 13.39 ng/mL (SD = 6.37), and the mean urinary ferritin level was 3.50 ng/mL (SD = 2.65). In controls, the mean serum ferritin level was 63.7 ng/mL (SD = 41.8), and the mean urinary ferritin level was 3.98 ng/mL (SD = 2.89). Urinary ferritin demonstrated lower diagnostic accuracy for iron deficiency anemia compared with serum ferritin. The Spearman correlation coefficient between serum and urinary ferritin was 0.155, indicating a weak positive correlation.
Conclusion: The findings of this study demonstrate an insignificant relationship between urine and serum ferritin levels. These findings indicate that urinary ferritin is not a reliable non-invasive alternative for diagnosing iron deficiency.

Keywords

Iron-Deficiency Anemia
Serum Ferritin
Urine Ferritin

Subjects

Copyright © 2026. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The license also allows users to adapt, remix, transform, and build upon the material for any purpose, including commercial use.

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Iranian Journal of Pathology
Volume 21, Issue 1
Winter 2026
Pages 41-46

  • Receive Date 03 January 2025
  • Revise Date 24 May 2025
  • Accept Date 10 October 2025

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