Assessment of erythropoiesis activity during hemodialysis therapy by soluble transferrin receptor levels and ferrokinetic measurements

Lorenzo, Javier Deira; Rodríguez, Mariano Martín; Martín, Serafina Sánchez; Romo, JoséM. Tabernero

doi:10.1016/s0272-6386(01)80012-3

Cited by 10 publications

(12 citation statements)

References 15 publications

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“…in 2001 also reported a positive correlation between hemoglobin, hematocrit and sTfR. [20] Further studies need to be done to have a consensus on the correlation of hemoglobin with sTfR in hemodialysis patients on iron and erythropoietin therapy.…”

Section: Discussionmentioning

confidence: 99%

Is soluble transferrin receptor a good marker of iron deficiency anemia in chronic kidney disease patients?

Gupta¹,

Uppal²,

Pawar³

2009

Indian J Nephrol

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Anemia in patients with chronic renal failure is multifactorial with an absolute or functional iron deficiency present in 60–80% of patients. In this study, 102 patients of stage 5 chronic kidney disease (CKD) were enrolled. Thirty six age- and sex-matched anemic patients without any known renal disease were taken as controls. Their sTfR levels were measured with anemia profile.(Fe, TIBC, Ferritin, TSAT). The patients were followed up twice, at four weeks and six months. There was a significant statistical difference in the mean sTfR levels in patients when compared to controls (P < 0.01).The mean level of sTfR in CKD patients was 3.23 ± 2.07 mg/l while in controls this was 5.16 ± 3.64 mg/l. sTfR had no statistically significant correlation with the levels of hemoglobin, iron, ferritin, TIBC and TSAT. We conclude that owing to complexity of iron metabolism in CKD, sTfR can not be used as a reliable marker of iron deficiency anemia.

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Section: Discussionmentioning

confidence: 99%

Is soluble transferrin receptor a good marker of iron deficiency anemia in chronic kidney disease patients?

Gupta¹,

Uppal²,

Pawar³

2009

Indian J Nephrol

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“…Transferrin saturation was also correlated, but negatively this time, with CRP possibly because of iron trapping in macrophages due to inflammation [19]. Serum transferrin receptor, a marker of both iron deficiency and erythropoiesis [20, 21], was negatively correlated with transferrin saturation, but positively with rHuEPO dose. …”

Section: Discussionmentioning

confidence: 99%

Does Hepcidin Affect Erythropoiesis in Hemodialysis Patients?

et al. 2006

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Introduction: Prohepcidin is the precursor of hepcidin, a liver-derived peptide involved in iron metabolism by blocking its intestinal absorption and its release by the reticuloendothelial system. Iron overload and inflammation increase hepcidin expression, whereas anemia and hypoxia suppress it. In the present study prohepcidin levels were determined in the serum of hemodialysis (HD) patients and its correlations with iron metabolism markers, C-reactive protein (CRP) and hematocrit (Hct) were assessed. Patients and Methods: Forty-sixHD patients and 22 healthy volunteers were enrolled in the study. Hct, serum prohepcidin, CRP, iron, ferritin, transferrin saturation and transferrin receptors were measured. The weekly erythropoietin dose, last-month intravenous iron dose and the patients’ demographics were recorded. Results: In comparison to the healthy volunteers, the HD patients had higher serum ferritin, transferrin receptors and CRP, lower serum iron and similar transferrin saturation and prohepcidin levels. In the patient group prohepcidin levels were negatively correlated with Hct but not with any other of the examined parameters. Multiple linear regression analysis considering age, inflammation, iron adequacy, erythropoietin dose and prohepcidin levels revealed that prohepcidin was the predominant determinant of Hct. Conclusions: Taking into account the low Hct levels in the HD patients of our study, it seems plausible that the prohepcidin levels assessed in this group are inappropriately high. These functionally high prohepcidin levels may be associated with the factors that inhibit erythropoiesis in HD patients. On the other hand, the absence of other expected correlations indicates that further studies are needed in order to definitely clarify this aspect.

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“…The synthesis of sTfR is increased under conditions of a reduced iron supply to the bone marrow and of enhanced erythropoiesis . Erythropoiesis activity that is enhanced by ESA increases sTfR levels in patients on dialysis . Thus, the significant change in sTfR levels caused by CERA in the present study would reflect increased iron utilization during erythropoiesis.…”

Section: Discussionmentioning

confidence: 51%

Effects of Long‐Term Erythropoiesis‐Stimulating Agents on Iron Metabolism in Patients on Hemodialysis

et al. 2015

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Continuous erythropoietin receptor activator (CERA) and darbepoetin-α (DA) might differently affect iron metabolism and erythropoiesis in patients on hemodialysis (HD). This prospective study examined a cohort of patients on HD who had received either intravenous CERA every 2 or 4 weeks (N = 25) or DA once each week (N = 47). Blood was sampled before HD sessions on days 0, 2, 4, 7 and 14, and on days 0, 3, 5, 7 and 14 from patients who were injected with ESA at the beginning and end of the dialysis week, respectively. Changes in factors indicating erythropoiesis and biomarkers of iron metabolism were examined. Hemoglobin levels were maintained in the target range between 10.0 and 11.0 g/dL and ferritin levels at baseline and during the study period were similar between the DA and CERA groups. Levels of hepcidin 25 decreased from days 2-3 to day 5 and returned to the baseline at day 7 in the DA group, whereas those and transferrin saturation were serially suppressed from days 2-3 to day 14 in the CERA group. Levels of soluble transferrin receptor and reticulocyte counts were significantly elevated from days 4-5 to day 14 by CERA. Both DA and CERA stabilized erythropoiesis, but CERA might mobilize iron from body stores more effectively than DA in patients on HD.

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Assessment of erythropoiesis activity during hemodialysis therapy by soluble transferrin receptor levels and ferrokinetic measurements

Cited by 10 publications

References 15 publications

Is soluble transferrin receptor a good marker of iron deficiency anemia in chronic kidney disease patients?

Is soluble transferrin receptor a good marker of iron deficiency anemia in chronic kidney disease patients?

Does Hepcidin Affect Erythropoiesis in Hemodialysis Patients?

Effects of Long‐Term Erythropoiesis‐Stimulating Agents on Iron Metabolism in Patients on Hemodialysis

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