Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
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

Login to get access

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

Other articles of this Issue 3/2012

Clinical and Experimental Nephrology 3/2012 Go to the issue

Original Article

Daily variance of urinary excretion of AQP2 determined by sandwich ELISA method

Original Article

High plasma pentosidine level is accompanied with cardiovascular events in hemodialysis patients

Case Report

Matrix metalloproteinase levels in peritoneal effluents were increased in a patient with appendicitis undergoing continuous ambulatory peritoneal dialysis

Original Article

The relationship between the soluble Klotho protein and the residual renal function among peritoneal dialysis patients

Images in Nephrology

Emphysematous cyst infection in autosomal dominant polycystic kidney disease

Case Report

A rare case of acute kidney injury associated with autoimmune hemolytic anemia and thrombocytopenia after long-term usage of oxaliplatin
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits