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Clinical and Experimental Nephrology
Published in: Clinical and Experimental Nephrology 3/2012

01-06-2012 | Original Article

The impact of ferritin fluctuations on stable hemoglobin levels in hemodialysis patients

Authors: Mana Yahiro, Takahiro Kuragano, Aritoshi Kida, Rie Kitamura, Minoru Furuta, Yukiko Hasuike, Yoshinaga Otaki, Hiroshi Nonoguchi, Takeshi Nakanishi

Published in: Clinical and Experimental Nephrology | Issue 3/2012

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Abstract

Background

Hemoglobin (Hb) cycling in patients with renal anemia might be associated with a higher mortality rate. We investigated the association of factors relating serum ferritin and dose of erythropoiesis-stimulating agents (ESAs) with Hb levels.

Methods

We measured Hb and ferritin levels every month in 266 hemodialysis (HD) patients for 12 months.

Results

The standard deviation (SD) and residual SD (RSD) (liner regression of Hb or ferritin SD values) values of Hb were significantly correlated with ferritin SD or RSD values, respectively. The percentage achievement of target Hb in the target-ferritin group was significantly higher than in the high-amplitude fluctuation ferritin group. Ferritin SD and RSD values in patients with oral or no iron supplementation were significantly lower than those who received intravenous iron.

Conclusion

Iron storage varies over a relatively wide range in HD patients, and this variation is closely associated with Hb cycling. The stability of iron storage and ESA dosage is important for maintaining stable Hb levels.
Literature
1.
Singh AK, Szczech L, Tang KL, Barnhart H, Sapp S, Wolfson M, CHOIR Investigators, et al. Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med. 2006;355:2085–98.PubMedCrossRef
2.
Drüeke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, CREATE Investigators, et al. Normalizaiton of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med. 2006;355:2071–84.PubMedCrossRef
3.
Besarab A, Bolton WK, Browne JK, Egrie JC, Nissnoson AR, Okamoto DM, et al. The effect of normal as compared with low hematocrit values in patients with cardiac disease who are receiving hemodialysis and epoetin. N Engl J Med. 1998;339:584–90.PubMedCrossRef
4.
Fishbane S, Berns JS. Hemoglobin cycling in hemodialysis patients treated with recombinant human erythropoietin. Kidney Int. 2005;68:1337–43.PubMedCrossRef
5.
Ebben JP, Gilbertson DT, Foley RN, Collins AJ. Hemoglobin level variability: association with comorbidity, intercurrent events, and hospitalization. Clin J Am Soc Nephrol. 2006;1(6):1205–10.PubMedCrossRef
6.
Yang W, Israni RK, Brunelli SM, Joffe MM, Fishbane S, Feldman HI. Hemoglobin variability and mortality in ESRD. J Am Soc Nephrol. 2007;18(12):3164–70.PubMedCrossRef
7.
Francisco ALM, Stenvinkel P, Vaulont S. Inflammation and its impact on anaemia in chronic kidney disease: from hemoglobin variability to hyporesponsiveness. NDT Plus. 2009;Suppl 1:i18–26.
8.
Kalantar-Zadeh K, Aronoff GR. Hemoglobin variability in anemia of chronic kidney disease. J Am Soc Nephrol. 2009;20:479–87.PubMedCrossRef
9.
Rozen-Zvi B, Gafter-Gvili A, Paul M, Leibovici L, Shpilberg O, Gafter U. Intravenous versus oral iron supplementation for the treatment of anemia in CKD: systematic review and meta-analysis. Am J Kidey Dis. 2008;52(5):897–906.CrossRef
10.
Kletzmayr J, Hörl WH. Iron overload and cardiovascular complications in dialysis patients. Nephrol Dial Transplant. 2002;17(Suppl 2):25–9.PubMedCrossRef
11.
Drüeke T, Witko-Sarsat V, Massy Z, Descamps-Latscha B, Guerin AP, Marchais SJ, et al. Iron therapy, advanced oxidation protein products, and carotid artery intima-media thickness in end stage renal disease. Circulation. 2002;106:2212–7.PubMedCrossRef
12.
Nakanishi T, Kuragano T, Nanami M, Otaki Y, Nonoguchi H, Hasuike Y. Importance of ferritin for optimizing anemia therapy in chronic kidney disease. Am J Nephrol. 2010;32(5):439–46.PubMedCrossRef
13.
Lim PS, Wei YH, Yu YL, Kho B. Enhanced oxidative stress in haemodialysis patients receiving intravenous iron therapy. Nephrol Dial Transplant. 1999;14:2680–7.PubMedCrossRef
14.
Daugirdas JT, Greene T, Depner TA, Gotch FA, Star RA. Relationship between apparent (single-pool) and true (double-pool) urea distribution volume. Kidney Int. 1999;56(5):1928–33.PubMedCrossRef
15.
Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease. J Jpn Soc Dial Ther. 2008;41(10):661–716.
16.
Canavese C, Bergamo D, Ciccone G, Longo F, Fop F, Thea A, et al. Validation of serum ferritin values by magnetic susceptometry in predicting iron overload in dialysis patients. Kidney Int. 2004;65:1091–8.PubMedCrossRef
17.
Locatelli F, Aljama P, Barany P, Canaud B, Carrera F, Eckardt KU, European Best Practice Guidelines Working Group, et al. Revised European Best Practice guidelines for the management of anaemia in patients with chronic renal failure. Nephrol Dial Transplant. 2004;19(suppl 2):ii1–47.PubMedCrossRef
18.
Provenzano R, Schiller B, Rao M, Coyne D, Brenner L, Pereira BJ. Ferumoxytol as an intravenous iron replacement therapy in hemodialysis patients. Clin J Am Soc Nephrol. 2009;4(2):386–93.PubMedCrossRef
19.
Lenga I, Lok C, Marticorena R, Hunter J, Dacouris N, Goldstein M. Role of oral iron in the management of long-term hemodialysis patients. Clin J Am Soc Nephrol. 2007;2(4):688–93.PubMedCrossRef
20.
Vanoaica L, Darshan D, Richman L, Schümann K, Kühn LC. Intestinal ferritin H is required for an accurate control of iron absorption. Cell Metab. 2010;12(3):273–82.
21.
Kuragano T, Shimonaka Y, Kida A, Furuta M, Nanami M, Otaki Y, et al. Determinants of hepcidin in patients on maintenance hemodialysis: role of inflammation. Am J Nephrol. 2010;31(6):534–40.PubMedCrossRef
22.
Chen JJ. Regulation of protein synthesis by the heme-regulated eIF2alpha kinase: relevance to anemias. Blood. 2007;109(7):2693–9.PubMed
Metadata
Title
The impact of ferritin fluctuations on stable hemoglobin levels in hemodialysis patients
Authors
Mana Yahiro
Takahiro Kuragano
Aritoshi Kida
Rie Kitamura
Minoru Furuta
Yukiko Hasuike
Yoshinaga Otaki
Hiroshi Nonoguchi
Takeshi Nakanishi
Publication date
01-06-2012
Publisher
Springer Japan
Published in
Clinical and Experimental Nephrology / Issue 3/2012
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-011-0584-0

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