The Growth Attainment, Hematological, Iron Status and Inflammatory Profile of Guatemalan Juvenile End-Stage Renal Disease Patients

Background. Influence of TMPRSS6 A736V and HFE (C282Y and H63D) polymorphisms on serum hepcidin-25 levels and iron status parameters in end-stage renal disease (ESRD) patients stratified according to gender has not been previously investigated. In addition, we aimed to evaluate the diagnostic accuracy of the parameters to separate iron-deficiency anemia (IDA) from anemia of chronic disease. Materials and Methods. Iron status parameters and genetic analysis were performed in 126 ESRD patients and in 31 IDA patients as the control group. Results. ESRD patients had significantly higher ferritin and hepcidin-25 (<0.001) relative to IDA patients. Cut-off values with the best diagnostic accuracy were found for hepcidin ≥9.32 ng/mL, ferritin ≥48.2 μg/L, transferrin saturation ≥16.8%, and MCV ≥81 fL. Interaction between gender and HFE haplotypes for the hepcidin-25 and ferritin levels in ESRD patients (p=0.005, partial eta squared=0.09; p=0.027, partial eta squared=0.06, respectively) was found. Serum transferrin was influenced by the combined effect of gender and TMPRSS6 A736V polymorphism in ESRD patients (p=0.002, partial eta squared=0.07). Conclusion. Our findings could contribute to the further investigation of mechanisms involved in the pathophysiology and important gender-related involvement of the TMPRSS6 and HFE polymorphisms on anemia in ESRD patients.

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The relation between vitamin D status and anemia in patients with end stage renal disease on regular hemodialysis

Journal of Renal Endocrinology ◽

10.34172/jre.2021.15 ◽

2021 ◽

Vol 7 (1) ◽

pp. e15-e15

Author(s):

Essam Nour el Din Afifi ◽

Ahmed Mohamed Tawfik ◽

Essam Eldin Rashed Saeed Abdulkhalek ◽

Lina Essam Khedr

Keyword(s):

Vitamin D ◽

Renal Disease ◽

Serum Calcium ◽

End Stage Renal Disease ◽

Iron Status ◽

Vitamin D Status ◽

Vitamin D Levels ◽

Stage Renal Disease ◽

End Stage ◽

Regular Hemodialysis

Introduction: Anemia is a common complication in end-stage renal disease (ESRD) patients on regular hemodialysis (HD). There has been a lot of interest recently in the non-classical effects of 25(OH) vitamin D (calcidiol), including its association with erythropoiesis and anemia pathogenesis. Objectives: To study the relation between anemia and vitamin D status in patients on regular HD Results: This study is a cross-sectional study that included 90 patients on regular HD. Vitamin D status was classified into deficient (<20 ng/ mL), insufficient (20-30 ng/mL) and sufficient (>30 ng/mL). The level of vitamin D measured in the patients ranged between 3.5 to 66 ng/mL with median of 16.35 ng/mL. There were statistically significant positive correlations between vitamin D levels and the level of hemoglobin (P<0.001), serum calcium levels (P<0.001) and serum PO4 levels (P=0.023). Higher hemoglobin levels were statistically related to both higher vitamin D values (P<0.001) and higher serum calcium concentration P<0.001). Meanwhile, a significant negative correlation was found between hemoglobin levels and serum PTH values (P<0.001). Conclusion: There was a significant association between the status of vitamin D and the level of hemoglobin in dialysis population who were studied, independent from iron status. other associations with hemoglobin levels included PTH level and calcium.

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Low-Dose Maintenance Intravenous Iron Therapy Can Prevent Anemia in Children with End-Stage Renal Disease Undergoing Chronic Hemodialysis

International Journal of Nephrology ◽

10.1155/2020/3067453 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Cahyani Gita Ambarsari ◽

Partini Pudjiastuti Trihono ◽

Agustina Kadaristiana ◽

Dedi Rachmadi ◽

Murti Andriastuti ◽

...

Keyword(s):

Treatment Group ◽

Renal Disease ◽

Maintenance Therapy ◽

End Stage Renal Disease ◽

Comparison Group ◽

Iron Status ◽

Iv Iron ◽

Stage Renal Disease ◽

End Stage ◽

Regular Hemodialysis

Iron deficiency anemia is common in children with end-stage renal disease (ESRD) on long-term hemodialysis receiving erythropoiesis-stimulating agents. One approach to maintain the iron profile and hemoglobin levels is maintenance therapy with regular low doses of intravenous (IV) iron after initial iron repletion therapy; however, evidence for the benefits of this approach is lacking. This study evaluated the effect of IV iron maintenance therapy on anemia in children on regular hemodialysis. This retrospective cohort study included 41 pediatric ESRD patients with normal hemoglobin and iron status who underwent regular hemodialysis at the Pediatric Dialysis Unit of Cipto Mangunkusumo Hospital, Indonesia, between January 2015 and April 2019. Among these, 21 received IV iron maintenance therapy with two doses of 2 mg/kg of IV iron sucrose every 2 weeks (the treatment group) and 20 did not (the comparison group). Changes in hemoglobin and transferrin saturation were assessed after 6 weeks of observation and compared between the two groups. There was a significant reduction in the mean hemoglobin level compared with the baseline level in the comparison group (21 g/L; 95% CI, 9.3–33 g/L; p=0.001) but not in the treatment group (0.7 g/L; 95% CI, −6.6–8 g/L; p=0.84). The risk of anemia was lower in the treatment group (relative risk = 0.42; 95% CI, 0.22–0.79; p=0.003). Although majority of the patients had high baseline ferritin level, this study indicates that in our setting, ferritin may not be a reliable parameter to review the iron status, as it can be affected by chronic inflammation. Hence, the decision to start IV iron maintenance therapy in patients with hyperferritinemia should consider the patient’s clinical condition and morbidity. To conclude, the coadministration of IV iron maintenance therapy is beneficial for maintaining hemoglobin levels and preventing anemia in children with ESRD who are undergoing regular hemodialysis, have achieved the target hemoglobin levels, and have normal iron status.

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Status of Selected Iron‐Status Biomarkers in Juvenile End‐ Stage Renal Disease in a Guatemalan Context: Comparative Aspects by Mode of Dialysis

The FASEB Journal ◽

10.1096/fasebj.27.1_supplement.223.8 ◽

2013 ◽

Vol 27 (S1) ◽

Author(s):

Juliana Casimiro ◽

Randall Lou‐Meda ◽

Marion Olbert ◽

Günter Weiss ◽

Dorine W Swinkels ◽

...

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Iron Status ◽

Stage Renal Disease ◽

End Stage

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Do Transferrin Levels Predict Haemodialysis Adequacy in Patients with End-Stage Renal Disease?

Nutrients ◽

10.3390/nu11051123 ◽

2019 ◽

Vol 11 (5) ◽

pp. 1123

Author(s):

Giovanni Tarantino ◽

Mauro Vinciguerra ◽

Annalisa Ragosta ◽

Vincenzo Citro ◽

Paolo Conforti ◽

...

Keyword(s):

Nutritional Status ◽

Renal Disease ◽

End Stage Renal Disease ◽

Iron Status ◽

Albumin Concentration ◽

Iron Storage ◽

Protein Energy ◽

Nutritional Risk Index ◽

Stage Renal Disease ◽

End Stage

Background: Since haemodialysis is a lifesaving therapy, adequate control measures are necessary to evaluate its adequacy and to constantly adjust the dose to reduce hospitalisation and prolong patient survival. Malnutrition is common in haemodialysis patients and closely related to morbidity and mortality. Patients undergoing haemodialysis have a high prevalence of protein-energy malnutrition and inflammation, along with abnormal iron status. The haemodialysis dose delivered is an important predictor of patient outcome. Aim: To evaluate through haemodialysis adequacy, which parameter(s), if any, better predict Kt/V, among those used to assess nutritional status, inflammation response, and iron status. Methods: We retrospectively studied 78 patients undergoing haemodialysis due to end-stage renal disease. As parameters of nutritional status, geriatric nutritional risk index (GNRI), transferrin levels, lymphocyte count, and albumin concentration were analysed. As signs of inflammation, C reactive protein (CRP) levels and ferritin concentrations were studied as well. Iron status was evaluated by both transferrin and ferritin levels, as well as by haemoglobin (Hb) concentration. Results: The core finding of our retrospective study is that transferrin levels predict the adequacy of haemodialysis expressed as Kt/V; the latter is the only predictor (P = 0.001) when adjusting for CRP concentrations, a solid marker of inflammation, and for ferritin levels considered an iron-storage protein, but also a parameter of inflammatory response. Discussion and Conclusion: In keeping with the results of this study, we underline that the use of transferrin levels to assess haemodialysis quality combine into a single test the evaluation of the three most important factors of protein-energy wasting.

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Do Insulin Resistance Conditions Further Impair the Lipid and Inflammatory Profile in End-Stage Renal Disease Patients on Hemodialysis?

Metabolic Syndrome and Related Disorders ◽

10.1089/met.2013.0124 ◽

2014 ◽

Vol 12 (4) ◽

pp. 220-226 ◽

Cited By ~ 3

Author(s):

Leonardo Cacciagiú ◽

Ana I. González ◽

Alicia Elbert ◽

Guillermo De'Marziani ◽

Tetsuo Machida ◽

...

Keyword(s):

Insulin Resistance ◽

Renal Disease ◽

End Stage Renal Disease ◽

Inflammatory Profile ◽

Stage Renal Disease ◽

End Stage

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POS-598 CLINICAL STUDY EVALUATING IRON STATUS AT END-STAGE RENAL DISEASE PATIENTS ON HEMODIALYSIS

Kidney International Reports ◽

10.1016/j.ekir.2021.03.627 ◽

2021 ◽

Vol 6 (4) ◽

pp. S262

Author(s):

K. OKASHA ◽

A. Alroz ◽

G. ElAzab

Keyword(s):

Clinical Study ◽

Renal Disease ◽

End Stage Renal Disease ◽

Iron Status ◽

Stage Renal Disease ◽

End Stage

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Role of Hepcidin as a biomarker for iron status in patients on regular hemodialysis

QJM ◽

10.1093/qjmed/hcab100.084 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Magdy M. El Sharkawy ◽

Mohamed Saeed Hassan ◽

Lina Essam Khedr ◽

Marco Monir Hanna

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Iron Status ◽

Ferritin Level ◽

Current Evidence ◽

Iron Level ◽

Iron Release ◽

Hepcidin Level ◽

Stage Renal Disease ◽

End Stage

Abstract Background The etiology of anemia in End Stage Renal Disease is multifactorial. Importantly, ESRD patients also have several abnormalities in systemic homeostasis of iron, an essential component in the production of red blood cells. Aim of the Work to assess hepcidin level in negative virology End Stage Renal Disease patients & its relation to iron level and erythropoiesis. Patients and Methods This study was conducted on 45 patients who are stage V chronic kidney disease on regular haemodialysis. Ten age and sex matched controls were included in the study. The study included 29 (64.4%) males and 16 (35.6%) females; their mean age was 53.40± 11.56 years. The prevalence of diabetes among the studied cases was 17.8%, while that of hypertensive was 42.2%. Mean of serum iron level was 64.23±19.53. Mean of TIBC was 409.96±67.85. Mean of Ferritin level 394.55±139.23 and mean of Hepcidin level was 218.51±127. Results Significant negative correlation between Hepcidin level and the Hemoglobin level, and highly significant positive correlation between Hepcidin level and serum Ferritin. Hepcidin up-regulation in the setting of CKD, with subsequent increased serum levels, results in impaired iron absorption from the intestine and decreased iron release from body storage sites. Ultimately, in the setting of such elevated levels, a state of functional iron deficiency may develop and lead to anemia due to iron-restricted erythropoiesis. Conclusion Based on current evidence, it seems likely that hepcidin represents a potentially modifiable mediator of anemia of CKD and is thus a potential target for future anemia therapy.

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