HLA Antigens and Serum Ferritin in Hemodialysis Patients

Abstract

The evolution of serum ferritin levels in Ill chronic-hemodialysis patients is prospectively studied. Patients were classified in two groups according to the presence or absence of’hemochromatosis antigens’ (HLA A3, B7 or B14) in their HLA typing. Levels of serum ferritin were similar in both groups before they started dialysis and during the first year. On the contrary, in the second and third hemodialysis years serum ferritin was higher in the group carrying ‘hemochromatosis antigens’. These differences were observed in patients treated with parenteral iron either in the form of transfusions or as intravenous dextran-iron but not in patients receiving oral iron. We conclude that the risk of developing iron overload is greater in hemodialysis patients with HLA A3, B7 or B14. Nevertheless, this potential risk can be minimized with a restrictive policy on the use of parenteral iron (transfusions, intravenous dextran-iron).

Serum Ferritin and Hemochromatosis Alleles in Chronic Hemodialysis Patients

“…This has been also observed in the general population [11][12][13] and recent reports confirmed this fact in HD patients [15].…”

“…The mean log SF of these pa tients was not significantly different from the highly trans fused HA-negative ones. So we cannot corroborate the claim that there is an increased risk of hemosiderosis in HA-positive HD patients when highly transfused [10,15]. We should emphasize that in our group of patients there are two precautions regarding iron administration: the first is the avoidance of the parenteral route and the second is suspending oral supplements of iron in the 6 months following every transfusion.…”

Successful Treatment of Hemodialysis-Related Porphyria cutanea tarda with Deferoxamine

“…In some patients on chronic dialysis the concentration of aluminium in plasma is elevated, which can also induce an increase of porphyrin synthesis [29]. It has been shown that the HLA antigens A3, B7 and B14 represent an additional risk factor for the development of iron overload in hemodialysis patients [30], According to these findings HLA typifying was performed in our patient and revealed the risk antigen HLA B7.…”

HLA Alleles, Hemochromatosis Allele, and Serum Ferritin in Hemodialysis Patients

“…They explained their observation by suggesting that in patients carrying these antigens the iron overload induced by parenteral iron does not inhibit intestinal iron absorption as it does in noncarriers. Numerous articles, cited by Quereda et al [1], also reported an association between these HLA antigens and an increase in ferritin levels in hemodialysis patients. Other authors [2.3], however, have not found such an association.…”

“…Thus, it is incorrect to intermingle carriers of A3, B7 or B14in one hemochroma tosis allele group. Quereda et al [1] provide an example of this confusion: only 29 of their patients in group 1 were A3 carriers and thus had an increased risk of carrying the hemochromatosis allele (and not the 37 patients who carried A3, B7 or B14).…”