scholarly journals Predictors of the response to treatment in anemic hemodialysis patients with high serum ferritin and low transferrin saturation

2007 ◽  
Vol 71 (11) ◽  
pp. 1163-1171 ◽  
Author(s):  
A.K. Singh ◽  
D.W. Coyne ◽  
W. Shapiro ◽  
A.R. Rizkala ◽  
the DRIVE Study Group
Keyword(s):  
Serum Ferritin ◽  
Transferrin Saturation ◽  
Hemodialysis Patients ◽  
High Serum ◽  
Response To Treatment

P1407LIVER, HEART AND BONE: THE PATH OF IRON OVERLOAD IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Lucas Acatauassu Nunes ◽  
Luciene Reis ◽  
Hanna Machado ◽  
Rosse Osório ◽  
Rosa Moyses ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Remodeling ◽  
Serum Ferritin ◽  
Bone Biopsy ◽  
Saturation Index ◽  
Transferrin Saturation ◽  
Hemodialysis Patients ◽  
High Serum ◽  
Cross Sectional ◽  
Osteoblast Activity

Abstract Background Chronic kidney disease (CKD) is associated with several comorbidities, including anemia, since with decreased renal function there is a decrease in erythropoietin (EPO) production and changes in iron (Fe) metabolism. In hemodialysis patients, prescription of Fe is indicated to supplement the needs of this element by maintaining ferritin levels above 100 mg/dl and transferrin saturation greater than 20%. However, the excess of Fe can generate free Fe not bound to transferrin, and deposit in organs such as liver, heart, and bone marrow, with consequent impairment of their function. In hemodialysis patients, the diagnosis of Fe overload, its clinical significance and therapeutic decision have been poorly studied, unlike thalassemia patients. Aims To assess whether hemodialysis patients with ferritin levels equal to or greater than 1000 mg/l also have Fe overload in liver, heart, and bone marrow, as well as compromise bone density and remodeling. Method This is a cross-sectional analysis that included 28 adult patients on regular conventional hemodialysis. Inclusion criteria were serum levels of ferritin ≥ 1000 mg/l, and ESRD treated by regular hemodialysis for at least 6 months. We excluded patients with HIV, cancer, hepatic disease, patients who received desferroxamine in the latest year, and those previously submitted to a kidney transplant. All patients underwent dual-energy X-ray absorptiometry (DXA), serum ferritin, transferrin saturation index (STI), Fe, C reactive protein (CRP), Calcium(Ca), phosphorus (P), parathyroid hormone (PTH) and alkaline phosphatase (AP) levels were recorded. T2* image acquisition of Magnetic Resonance Imaging (MRI) 1,5 Tesla, were used for the assessment of Fe of liver, and heart. R2* and R2* Water were used of liver and bone (iliac crest). Bone biopsy was also performed. Results We evaluated 28 hemodialysis patients with a mean age of 55.8±13.1, hemodialysis time of 42.5±26.5 and iron use in the year prior to study enrollment of 311.5±179.8 mg/month. Biochemical analysis showed 3 patients with Hb below 9.0 mg/dl and 14 with values above 11.5 mg/dl; 6 patients with SatFe <30% and 12 patients with ferritin >1500mg/dl; 16 patients with PTH <300pg/ml and eight with >600pg/dl. MRI revealed Fe overload in the liver and bone tissue (figure 1) of all patients but not in the heart. Serum ferritin levels correlated with liver and bone overload (figure 2). Densitometry and bone biopsy results were not affected by Fe overload, however, serum Fe levels were associated with lower bone remodeling and mineralization suggesting an effect of this element on osteoblast activity. Conclusion High serum ferritin is associated with liver and bone marrow Fe overload, but not heart, as well as with low bone remodeling and mineralization. We must be aware of these side effects of high doses of Fe that are commonly used in these patients.

scholarly journals Both low and high serum ferritin levels predict mortality risk in hemodialysis patients without inflammation

2016 ◽  
Vol 21 (4) ◽  
pp. 685-693 ◽  
Author(s):  
Tetsuo Shoji ◽  
Kakuya Niihata ◽  
Shingo Fukuma ◽  
Shunichi Fukuhara ◽  
Tadao Akizawa ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Mortality Risk ◽  
Hemodialysis Patients ◽  
High Serum

scholarly journals Optimization of Epoetin Therapy with Intravenous Iron Therapy in Hemodialysis Patients

2000 ◽  
Vol 11 (3) ◽  
pp. 530-538
Author(s):  
ANATOLE BESARAB ◽  
NEETA AMIN ◽  
MUHAMMAD AHSAN ◽  
SUSAN E. VOGEL ◽  
GARY ZAZUWA ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Transferrin Saturation ◽  
Intravenous Iron ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Control Group ◽  
Zinc Protoporphyrin ◽  
Study Group ◽  
Iron Deficient

Abstract. Iron deficiency limits the efficacy of recombinant human erythropoietin (rhEPO) therapy in end-stage renal disease (ESRD) patients. Functional iron deficiency occurs with serum ferritin >500 ng/ml and/or transferrin saturation (TSAT) of 20 to 30%. This study examines the effects of a maintenance intravenous iron dextran (ivID) protocol that increased TSAT in ESRD hemodialysis patients from conventional levels of 20 to 30% (control group) to those of 30 to 50% (study group) for a period of 6 mo. Forty-two patients receiving chronic hemodialysis completed a 16- to 20-wk run-in period, during which maintenance ivID and rhEPO were administered in amounts to achieve average TSAT of 20 to 30% and baseline levels of hemoglobin of 9.5 to 12.0 g/dl. After the run-in period, 19 patients randomized to the control group received ivID doses of 25 to 150 mg/wk for 6 mo. Twenty-three patients randomized to the study group received four to six loading doses of ivID, 100 mg each, over a 2-wk period to achieve a TSAT >30% followed by 25 to 150 mg weekly to maintain TSAT between 30 and 50% for 6 mo. Both regimens were effective in maintaining targeted hemoglobin levels. Fifteen patients in the control group and 17 patients in the study group finished the study in which the primary outcome parameter by intention to treat analysis was the rhEPO dose needed to maintain prestudy hemoglobin levels. Maintenance ivID requirements in the study group increased from 176 to 501 mg/mo and were associated with a progressive increase in serum ferritin to 658 ng/ml. Epoetin dose requirements for the study group decreased by the third month and remained 40% lower than for the control group, resulting in an overall cost savings in managing the anemia. Secondary indicators of iron-deficient erythropoiesis were also assessed. Zinc protoporphyrin did not change in either group. Reticulocyte hemoglobin content increased only in the study group from 28.5 to 30.1 pg. It is concluded that maintenance of TSAT between 30 and 50% reduces rhEPO requirements significantly over a 6-mo period.

scholarly journals Older Age and High Serum Ferritin Levels Associated With the Risk of Chronic Cytopenia in Hemodialysis Patients

2020 ◽  
Vol 7 ◽  
Author(s):  
Yu-Ting Lee ◽  
Wei-Yu Wang ◽  
Chin-Ho Kuo ◽  
Ming-Yang Lee ◽  
Yin-Che Lu ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Hemodialysis Patients ◽  
High Serum ◽  
Older Age

scholarly journals Abnormalities in Iron Metabolism in Multiple Sclerosis

1989 ◽  
Vol 16 (2) ◽  
pp. 184-186 ◽  
Author(s):  
Leslie S. Valberg ◽  
Peter R. Flanagan ◽  
Ann Kertesz ◽  
George C. Ebers
Keyword(s):  
Multiple Sclerosis ◽  
Serum Ferritin ◽  
Iron Metabolism ◽  
Transferrin Saturation ◽  
High Serum ◽  
Red Cell ◽  
Hemochromatosis Gene ◽  
Severity Of The Disease ◽  
Bilateral Assistance ◽  
Relationship Of

ABSTRACT:High iron concentrations have been reported in the brains of multiple sclerosis victims. To determine if there are abnormalities in general iron metabolism indicative of iron overload in MS, measurements of transferrin saturation, serum ferritin and red cell ferritin in 31 female and 18 male patients were compared to the results in 49 age- and sex-matched healthy controls. Compared to controls, mean serum ferritin in MS was high, whereas transferrin saturation and red cell ferritin were similar. High values in one or more individual test results were observed in eleven MS patients. They were prevalent in patients who required bilateral assistance to walk or were confined to a chair, and appeared to be related to the severity of the disease. An investigation was made into the relationship of the high serum ferritin values in MS to the HLA-A3 histocompatibility antigen, a marker of the hemochromatosis gene which is prevalent in MS. A statistically significant interaction was not found between serum ferritin and the presence of HLA-A3.

Childhood Onset Hypoceruloplasminemia Presenting as Early-Onset rebellar Ataxia

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Adel F. Hashish ◽  
Ayman Kilany ◽  
Shora Y. Darwish ◽  
Hanaa M. Rashad ◽  
Ehab R. Abdelraou ◽  
...  
Keyword(s):  
Retinal Degeneration ◽  
Cerebellar Ataxia ◽  
Serum Ferritin ◽  
Transferrin Saturation ◽  
Autosomal Recessive Disorder ◽  
Molecular Study ◽  
High Serum ◽  
Control Group ◽  
Serum Ceruloplasmin ◽  
Low Serum

The syndrome of hypoceruloplasminemia is a rare autosomal recessive disorder presenting mainly with neurogegeneration, retinal degeneration, and diabetes mellitus. The syndrome, to the best of our knowledge, is not yet recognized in pediatric age group. We screened cases presenting with unexplained cerebellar ataxia and anemia using serum ceruloplasmin, transferrin saturation, and ferritin as biomarkers for hypoceruloplasminemia. An age and sex matched control group was included. Thirty cases (age range 4–17 years) (18 male and 12 female) have been included. The results showed a statistically significant low serum ceruloplasmin and transferrin saturation (18.9±12.1mg/dl and 10.1±5.1%, respectively), and high serum ferritin (124.7±65.7 ng/ml) compared to control group. Four cases have retinal degeneration. The detection of low serum ceruloplasmin concentration and transferrin saturation with high serum ferritin in patients with unexplained cerebellar ataxia is highly suspicious of hypocerluplasminemia which should be subjected for further molecular study.

Sign in / Sign up

Export Citation Format

Share Document