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New parameters in iron metabolism and functional iron deficiency in patients on maintenance hemodialysis.
MedLine Citation:
PMID:  23111696     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION In the recent years new parameters in iron metabolism were described as well as the problem of functional iron deficiency. Functional iron deficiency is characterised by the presence of adequate iron stores as defined by conventional criteria, but with insufficient iron mobilisation to adequately support erythropoiesis with the administration of erythropoiesis stimulating agents.  OBJECTIVES The aim of this study was to test the hypothesis whether new parameters of iron metabolism are related to functional iron deficiency in stable hemodialysis patients. PATIENTS AND METHODS Iron status, complete blood count, creatinine, calcium, phosphorus, albumin, iPTH and serum lipids were assessed using standard laboratory methods. High sensitivity C-Reactive Protein (hsCRP), IL-6 (interleukin-6), NT-proBNP (N-terminal-proBrain Natriuretic Peptide), hepcidin, BMP-6 (bone morphogenic protein) and GDF15 (growth differentiation factor 15) were measured using commercially available kits.  RESULTS BMP-6, GDF15 were similar in patients with and without functional iron deficiency. Functional iron deficiency was present in 23% of the studied hemodialysis patients and  associated with significantly higher serum ferritin, IL-6, hsCRP and hepcidin levels, higher NT-proBNP levels, lower Kt/V (kinetic of urea modeling), increased prevalence of hypertension and diabetes and higher erythropoietin doses. It was predicted by serum iron and residual renal function. Left ventricular hypertrophy and left ventricular internal end-systolic dimension were also significantly more severe in hemodialysis patients with functional iron deficiency. CONCLUSIONS New parameters in iron metabolism were unrelated to functional iron deficiency, present in considerable group of hemodialysis patients. This population should be carefully screened for possible reversible causes of inflammation and then adequately treated.
Authors:
Jolanta Małyszko; Ewa Koc-Żórawska; Nomy Levin-Iaina; Jacek Małyszko; Piotr Koźmiński; Grażyna Kobus; Michał Myśliwiec
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-30
Journal Detail:
Title:  Polskie Archiwum Medycyny Wewnetrznej     Volume:  -     ISSN:  1897-9483     ISO Abbreviation:  Pol. Arch. Med. Wewn.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401225     Medline TA:  Pol Arch Med Wewn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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