Iron and gepsidin metabolism in patients with chronic kidney disease 5d stage

Abstract

THE AIM: to identify ferrokinetic indicators in patients with chronic kidney disease 5D stage receiving treatment by hemodialysis. PATIENTS AND METHODS. Research included 100 patients with chronic kidney disease 5D stage receiving hemodialysis, among them 51 women and 49 men, mean age was 53,4±15,8 years. All patients were performed complex laboratory tests. RESULTS. There was statistically significant correlation between hemoglobin level and some ferrokinetic indicators. Hemoglobin level was directly correlated with serum iron (r=0,30; p=0,002), transferrin saturation (r=0,30; p=0,020), the effective transport concentration of iron (r=0,29; p=0,002), effectiveness of hemodialysis - Kt/v (r=0,22; p=0,0028), total protein (r=0,34; p=0,0006) and albumin (r=0,23; p=0,02), inverse correlation was established with fluctuation-dose erythropoietin (r=-0,46; p=0,01) and iron (r=-0,51; p=0,004) in last 12 months. In patients receiving hemodialysis for more than 12 months, it was observed a positive correlation between hepcidin level and hemodialysis duration (r=0.41; p=0,004), negative correlation was found between hepcidin and erythropoietin dose fluctuation for 3 (r=-0,52; p=0,003), 6 (r=-0,43; p=0,003), 12 (r=-0,5; p=0,04) months and hemoglobin fluctuation level for 3 (r=-0,4; p=0,01) and 6 (r=-0,5; p=0,0004) months. CONCLUSION. Hemoglobin level in patients with end-stage renal failure depends on quality of hemodialysis, iron transport pool and erythropoietin therapy mode. Thus, improvement of hemodialysis technical capabilities, correction of protein metabolism disorders, modification of erythropoiesis stimulating therapy are therapeutic targets in fight against anemia.