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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
Author(s) -
Casimiro Juliana,
LouMeda Randall,
Olbert Marion,
Weiss Günter,
Swinkels Dorine W,
Tjalsma Harold,
Solomons Noel W,
Schümann Klaus
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.223.8
Subject(s) - medicine , ferritin , peritoneal dialysis , gastroenterology , hemodialysis , anemia , end stage renal disease , hepcidin , context (archaeology) , dialysis , dialysis adequacy , erythropoietin , paleontology , biology
Background Anemia is common in end‐stage renal disease (ESRD) with both inflammation and reduced erythropoietin exerting an important role. Objective To assess selected iron (Fe) biomarkers in Guatemalan low‐income patients on hemodialysis (HD) and peritoneal dialysis (PD). Methods Iron biomarkers were determined in 27 juveniles after HD and 27 on PD therapy (7–20 y). Results Hb mean was 9.0±1.9 g/dL in HD and 9.9±2.7 g/dL in PD (p=0.17). Respective ranges for serum Fe were 24–148 and 30–175 μg/dL (p=0.29); for transferrin were 7–63 and 12–103 ng/mL (p=0.23); for sTfR were 1.8–6.1 and 0.3–7.1 mg/L (p=0.14); for ferritin 193–4,113 and 17–1,506 ng/mL (p=0.01) and hepcidin‐25 (hep‐25) median values were 36 and 43 nM (p=0.68). Ferritin correlated significantly with hep‐25 in PD (r=0.72; p<0.001), but not in HD (r=0.04; p=0.82). Conclusions Higher ferritin status and its low correlation with hep‐25 in HD may in part be due to high parenteral Fe vs. oral Fe administration in PD. Overall levels of ferritin and hep‐25 in juvenile, Guatemalan ESRD patients were 4–5 times higher than Dutch adults (Peters et al, Nephrol Dial Transplant, 2010; 25: 848–53). This is possibly related to an inflammatory overlay of the low‐income setting that leads to high hep‐25 associated and to macrophage iron withholding and Fe‐restricted erythropoiesis. Funded by Hildegard Grunow Foundation, Munich and MBR Optical Systems, Wuppertal