scholarly journals Factors Influencing Hemoglobin Variability and Its Association with Mortality in Hemodialysis Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Zeynep Bal ◽  
Bahar Gurlek Demirci ◽  
Suleyman Karakose ◽  
Emre Tutal ◽  
Mehtap Erkmen Uyar ◽  
...  
Keyword(s):  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
High Amplitude ◽  
Hemodialysis Patients ◽  
Amplitude Fluctuation ◽  
Target Range ◽  
Hemoglobin Variability ◽  
Factors Influencing ◽  
Low Amplitude

Purpose. We aimed to investigate the factors influencing hemoglobin variability with inflammatory and nutritional parameters and its associations with all-cause mortality among hemodialysis patients. Methods. One hundred and sixty-nine patients during the entire 12 months were enrolled into the study. Fasting plasma glucose, creatinine, calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH), C-reactive protein (CRP), serum iron, serum iron-binding capacity, and transferrin saturation were analyzed. We defined six groups: low, target range, high, low-amplitude fluctuation with low hemoglobin levels, low-amplitude fluctuation with high hemoglobin levels, and high-amplitude fluctuation. Body mass index (BMI), malnutrition-inflammation score (MIS), and Charlson Comorbidity Index were evaluated. Results. Hemoglobin variability was significantly correlated with age, platelet count, and number of hospitalization instances and inversely correlated with erythropoietin dose per body surface area. The coefficient of variation of hemoglobin showed a correlation with MIS and ferritin. The absolute level of hemoglobin showed a negative correlation between PTH, CRP, MIS, number of hospitalization instances and a positive correlation with albumin and BMI. High, low, and target-range groups showed survival advantage compared to the other three groups. In regression analysis, age, CRP levels, MIS, and BMI were the predictors of mortality. Conclusion. Inflammation and duration of anemia were the major predictors of hemoglobin variability. High-amplitude fluctuation predicts high mortality; on the contrary low-amplitude fluctuations is related to better survival. MIS was independently associated with mortality. This trial is registered with NCT03454906.

scholarly journals Variability in Hemoglobin Levels and the Factors Associated with Mortality in Hemodialysis Patients: A 78-Month Follow-Up Study

2021 ◽  
Vol 18 (3) ◽  
pp. 1078
Author(s):  
Natalino Salgado Filho ◽  
Joyce Lages ◽  
Dyego Brito ◽  
Elton Santos ◽  
Alcione dos Santos ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Transferrin Saturation ◽  
High Amplitude ◽  
Blood Parameters ◽  
Amplitude Fluctuation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Low Amplitude

Some studies have described that when the hemoglobin levels of chronic kidney disease (CKD) patients change, especially in those taking erythropoiesis-stimulating agents (ESA), they are associated with unfavorable outcomes such as increased morbidity and mortality, mainly due to cardiovascular events. This prospective cohort study included patients with end-stage renal disease currently undergoing hemodialysis. The initial 6-month clinical evaluation provided data of the variability in hemoglobin, associated blood parameters, and the use of erythropoietin. Subsequently, the patients were followed up for 78 months to evaluate mortality-associated factors. In total, 133 patients completed the 6-month follow-up with a mean age of 47.1 (±13.2) years. The majority were women (51.9%). Six-month hemoglobin levels were as follows: always low (18.0%), intermediate/target (1.5%), always high (0.8%), low-amplitude fluctuation/Hb low (n = 37; 27.8%), low-amplitude fluctuation/Hb high (13.53%), and high-amplitude fluctuation (38.6%), among end-stage renal disease patients. At the end of 78 months, 50 (37.6%) patients died; 70% of deaths were attributed to cardiovascular etiologies. A high variability was observed in hemoglobin levels, which was not associated with mortality. Among all the variables evaluated, age, erythropoietin dose, and transferrin saturation were associated with a higher mortality. Thus, this study suggests that greater attention to erythropoietin doses and transferrin saturation levels may improve the survival of dialysis patients.

scholarly journals Iron serum levels and iron homeostasis parameters in patients with nosocomial pneumonia treated with cefiderocol: post hoc analysis of the APEKS-NP study

2022 ◽  
Author(s):  
Eric P. Skaar ◽  
Roger Echols ◽  
Yuko Matsunaga ◽  
Anju Menon ◽  
Simon Portsmouth
Keyword(s):  
Nosocomial Pneumonia ◽  
Serum Iron ◽  
Iron Homeostasis ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Efficacy And Safety ◽  
Baseline Serum ◽  
Post Hoc Analysis ◽  
Iron Binding Capacity ◽  
Post Hoc

AbstractCritically ill patients often present with low serum iron levels or anemia. We evaluated the impact of iron levels and iron homeostasis on the efficacy and safety of cefiderocol, an iron-chelator siderophore cephalosporin, in patients with nosocomial pneumonia in a post hoc analysis of the randomized, double-blind, Phase 3 APEKS-NP study (NCT03032380). Patients with Gram-negative nosocomial pneumonia received cefiderocol 2 g, 3-h infusion, q8h, or high-dose, extended-infusion meropenem 2 g, 3-h infusion, q8h, for 7–14 days. Efficacy and safety parameters, including specific iron homeostasis parameters (i.e., hepcidin, iron, total iron binding capacity, transferrin saturation), were analyzed according to baseline iron levels. In the cefiderocol and meropenem arms, 79.1% (117/148) and 83.3% (125/150) randomized patients, respectively, had low baseline serum iron levels. Rates of 14-day (12.3% [14/114] vs 11.6% [14/121]) and 28-day all-cause mortality (20.5% [23/112] vs 19.0% [23/121]), clinical cure (63.2% [72/114] vs 67.2% [82/122]), and microbiological eradication (43.6% [41/94] vs 48.1% [51/106]) at test of cure were similar in cefiderocol vs meropenem arms, respectively. In the overall safety population, rates of anemia-related adverse events were similar (cefiderocol arm 18.2% [27/148], meropenem arm 18.7% [28/150]). Changes from baseline to test of cure in hepcidin, iron, total iron binding capacity, and transferrin saturation were similar between treatment arms. Cefiderocol treatment did not affect iron homeostasis, and its efficacy and safety were not influenced by baseline serum iron levels. Clinicaltrials.gov registration: NCT03032380. Date of registration: 26 January 2017.

Serum iron and total iron-binding capacity compared with serum ferritin in assessment of iron deficiency.

1981 ◽  
Vol 27 (2) ◽  
pp. 276-279 ◽  
Author(s):  
F Peter ◽  
S Wang
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Total Iron ◽  
Iron Binding ◽  
Total Iron Binding Capacity ◽  
Iron Deficient ◽  
Iron Binding Capacity

Abstract Ferritin values for 250 selected sera were compared with values for iron, total iron-binding capacity (TIBC), and transferrin saturation, to assess the potential of the ferritin assay for the detection of latent iron deficiency. The specimens were grouped (50 in each group) according to their values for iron and TIBC. In Group 1 (low iron, high TIBC) the saturation and ferritin values both indicated iron deficiency in all but one. In the 100 specimens of Groups 2 (normal iron, high TIBC) and 4 (normal iron, high normal TIBC), the saturation values revealed 16 iron-deficient cases, the ferritin test 55. For Groups 3 (low iron, normal TIBC) and 5 (low iron, low TIBC), the ferritin test revealed fewer cases of iron deficiency than did the saturation values (37 cases vs 51 cases, in the 100 specimens). Evidently the ferritin test detects iron deficiency in many cases for whom the serum iron and TIBC tests are not positively indicative. The correlation of serum ferritin with iron, TIBC, and transferrin saturation in the five groups was good only in the case of specimens for which the TIBC was normal; if it was abnormal the correlation was very poor.

Subclinical Iron Deficiency in Non-Anemic Individuals: A Retrospective Analysis of Korean Health Examinees

2019 ◽  
Vol 143 (1) ◽  
pp. 26-32
Author(s):  
Eun-Hee Nah ◽  
Han-Ik Cho ◽  
Seon Cho ◽  
Suyoung Kim
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Reproductive Age ◽  
Iron Level ◽  
Distribution Width ◽  
Elderly Males ◽  
Males And Females

Objectives: Non-anemic individuals may have undetected subclinical iron deficiency (SID). The aims of this study were to determine the prevalence of SID and identify the associated factors for SID. In addition, the screening performance of red blood cell (RBC) indices for SID in health check-ups was assessed. Methods: This study was conducted with 16,485 non-anemic health examinees (3,567 males and 12,918 females) who underwent tests for iron variables (serum iron, total iron-binding capacity, ferritin, and iron saturation) at 16 health-promotion centers in 13 cities in Korea between January 2017 and June 2018. SID was defined as a decreased ferritin level (<24 µg/L in males and <15 µg/L in females) and either a decreased serum iron level (<44 µg/dL in males and <29 µg/dL in females) or a transferrin saturation of <20%. Results: The prevalence rates of SID were 0.6 and 3.3% in males and females, respectively. In terms of age and sex, SID was most prevalent in males aged ≥70 years (7.8%) and females aged 15–49 years (7.6%). There were significant differences in the hemoglobin (Hb) level, white blood cell count, platelet count, mean corpuscular volume, mean corpuscular Hb (MCH), and RBC distribution width (RDW) between the SID and non-SID groups (p < 0.001). The factors associated with SID in males were older age (odds ratio, OR, 1.069, 95% confidence interval, CI, 1.03–1.109, p = 0.004), lower Hb (OR 0.58, 95% CI 0.345–0.976, p = 0.04), lower MCH (OR 0.433, 95% CI 0.298–0.629, p < 0.001), and higher RDW (OR 1.374, 95% CI 1.001–1.887, p = 0.049), while in females they were lower body mass index (BMI; OR 0.929, 95% CI 0.895–0.963, p < 0.001) and younger age (OR 0.954, 95% CI 0.945–0.963, p < 0.001), as well as lower Hb, lower MCH, and higher RDW. The AUC for the MCH (0.877, 95% CI 0.793–0.960 in males; 0.872, 95% CI 0.853–0.890 in females) indicates that the MCH at cut-offs of 29.2 and 29.3 pg are the best discriminators of SID in males and females, respectively (p < 0.001). Conclusions: Reproductive-age females with a lower BMI and elderly males are high-risk groups for SID. MCH is a reliable RBC index for the screening of SID. For the population with defined risk factors, including females with lower BMI and elderly males, screening for SID is needed to prevent the development of anemia.

Interaction Between Genotypes for HFE and TFR2 Genes Mutations and Iron Status in Brazilian Blood Donors

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5382-5382
Author(s):  
Rodolfo D Cancado ◽  
Paulo CJL Santos ◽  
Samuel Rostelato ◽  
Cristiane T Terada ◽  
Iris Gonzales ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Serum Iron ◽  
Blood Donors ◽  
Binding Capacity ◽  
Iron Status ◽  
Hereditary Hemochromatosis ◽  
Transferrin Saturation ◽  
The Body ◽  
Hfe Gene ◽  
Automation System

Abstract Hereditary hemochromatosis (HH) is a disorder characterized by increased intestinal iron absorption, which leads to a progressive accumulation of iron in the body. This iron overload has been associated with mutations in HFE gene (C282Y, H63D and S65C) and other genes. The objectives of this study were to assess the frequencies of functional mutations in HFE and TFR2 genes and to investigate their relationship with the iron status in a sample of blood donors. Blood donors (n=542) were recruited at the Hemocenter of the Santa Casa Hospital, Sao Paulo, Brazil. The genotypes for HFE (C282Y, H63D and S65C) TFR2 (Y250X and Q690P) gene mutations were evaluated by PCR-RFLP. The concentrations of serum iron and total iron-binding capacity (TIBC) were measured by automation system Advia®(Bayer Diagnostics) and serum ferritin by Axsym System®(Abbott Laboratories). The frequencies of HFE 282Y, HFE 63D and HFE 65C alleles were 2.1, 13.6 and 0.6%, respectively. The frequency C282Y allele (2.1%) in Brazilian blood donors is lower than that observed in blood donors from Northern Europe (5.1 to 8.2%, P&lt;0.05). The TFR2 250X and TFR2 690P alleles were not found in these subjects. The iron status was similar between HFE genotypes in women. However, men carrying HFE 282CY genotype had higher serum ferritin and lower TIBC concentrations when compared to the HFE 282CC genotype carriers. HFE 282CY genotype was also associated with higher transferrin saturation in men who donated blood at the first time. Moreover, male donors with HFE 63DD plus 63HD genotypes had higher serum iron and transferrin saturation when compared to those with HFE 63HH genotype. A relationship between HFE CY/HH/SS haplotype and lower TIBC concentrations was also found in men. The HFE 282Y and HFE 65C alleles were rare while the HFE 63D was frequent in blood donors. The mutations in TFR2 gene were not found in this study. The HFE 282Y and HFE 63D alleles were associated with alterations on iron status only in male blood donors.

scholarly journals Plasma Volume Is an Important Determinant in Assessing Metabolic and Iron Biomarkers in Young Women

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 94-94
Author(s):  
Sixtus Aguree ◽  
Manju Reddy
Keyword(s):  
Plasma Volume ◽  
Serum Iron ◽  
Serum Lipids ◽  
Binding Capacity ◽  
Venous Blood ◽  
Transferrin Saturation ◽  
Normal Weight ◽  
Obese Women ◽  
Funding Sources ◽  
Adjustment Factors

Abstract Objectives Plasma volume (PV) variations among individuals can affect the concentration of blood biomarkers but this is not often evaluated in assessing nutritional status. We aimed to assess the association between estimated PV, metabolic and iron biomarkers in young obese and normal weight women. Methods Healthy women aged 18–30 y were recruited for the study (n = 47: 25 obese and 22 normal weight). Fasting venous blood samples were obtained to measure serum lipids, comprehensive metabolic panel, iron biomarkers (serum iron, total iron binding capacity, transferrin saturation (%TS), hemoglobin, ferritin and, hepcidin). PV was estimated using Kaplan-Hakim formula: PV = (1-hematocrit) × [a + (b × weight in kg)] where adjustment factors were a = 864, and b = 47.9. Associations between PV and other biomarkers were assessed using Pearson's correlation. Results As expected, PV was higher in obese (3482 (545) mL) than normal weight women (2268 (250) mL). When all subjects were combined PV was negatively correlated with HDL (r = −0.49, P = 0.001), creatinine (r = −0.48, P = 0.001), sodium (r = −0.31, P = 0.034), calcium (r = −0.30, P = 0.044), albumin (r = −0.46, P = 0.001), serum iron (r = −0.34, P = 0.022), and %TS (r = −0.31, P = 0.036) but positively correlated with triglycerides (r = 0.40, P = 0.005), cholesterol/HDLC ratio(r = 0.55, P &lt; 0.001). In normal weight women, PV was not correlated with any of these biomarkers. However, in obese women, there was a strong correlation of PV with creatinine (r = −0.61, P = 0.001), calcium (r = −0.50, P = 0.012), and albumin (r = −0.43, P = 0.030). Conclusions Our results suggest that differences in PV may account for some variations in serum lipids, creatinine, sodium, calcium, albumin, and iron biomarker concentrations in women. This implies that different cutoffs may be needed for defining deficiencies in obesity after correcting for plasma volume. Funding Sources Doris A. Adams Endowed Chair funds at Iowa State University.

scholarly journals Gambaran status besi pada pasien penyakit ginjal kronik stadium 5 dengan anemia yang menjalani hemodialisis reguler

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Bryan J. Silaban ◽  
Cerelia Sugeng ◽  
Bradley J. Waleleng
Keyword(s):  
End Stage Renal Disease ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Total Iron ◽  
Iron Binding ◽  
Total Iron Binding Capacity ◽  
Stage Renal Disease ◽  
End Stage ◽  
Iron Binding Capacity

Abstract: Chronic kidney disease (CKD) is a pathological condition with a variety of etiology, resulting in progressively decreased renal function which is often ended with kidney failure. Chronic kidney disease has a global prevalence of 800 per million of population and the incidence of end-stage renal disease ranges from 150 to 200 per million of population. Complications often occur at the end-stage renal disease inter alia anemia with a rate of 80-90%. This study was aimed to obtain the profile of stage-5 CKD patients with anemia and regular hemodialysis was performed on them. This was a descriptive-retrospective study using data of medical records at Prof. Dr. R. D. Kandou General Hospital from January 2015 to October 2016. There were six observed variables as follows: age, gender, serum iron (SI), total iron binding capacity (TIBC), transferrin saturation, and ferritin. The results showed that of the 48 CKD patients with anemia, there were 24 males and 24 females. The majority were aged 60-69 years (33%) and had normal SI level in 30 patients (67%); decreased TIBC in 35 patients (75%); normal transferrin saturation in 26 patients (54%); and increased ferritin level in 38 patients (81%). Conclusion: Majority of the patients were 60-69 years old and had normal level of SI, decreased TIBC, normal transferrin saturation, and increased levels of ferritin. There was no difference in case number of both sexes.Keywords: serum iron, total iron binding capacity, transferrin saturation, ferritin Abstrak: Penyakit Ginjal Kronik (PGK) adalah suatu keadaan patologis dengan etiologi yang beragam, terjadi penurunan fungsi ginjal secara progresif, dan biasanya berakhir dengan gagal ginjal. Penyakit ginjal kronik merupakan salah satu masalah kesehatan di dunia dengan prevalensi 800 per juta populasi dan insidensi end-stage renal disease (ESRD) 150-200 per juta populasi di dunia. Komplikasi sering terjadi pada PGK stadium akhir antara lain anemia dengan persentase mencapai 80-90%. Penelitian ini bertujuan untuk mendapatkan profil pasien PGK stadium 5 dengan anemia dan menjalani hemodialisis reglular. Jenis penelitian ialah deskriptif-retrospektif menggunakan data sekunder dari catatan rekam medik periode Januari 2015 – Oktober 2016 di RSUP Prof. Dr. R. D. Kandou Manado dengan enam variabel penelitian, yaitu usia, jenis kelamin, serum iron (SI), total iron binding capacity (TIBC), saturasi transferin, dan feritin. Dari 48 data rekam medik pasien yang memenuhi kriteria inklusi ditemukan bahwa mayoritas pasien berumur 60-69 tahun (33%), laki-laki maupun perempuan berjumlah sama, mayoritas pasien memiliki kadar SI normal berjumlah 30 pasien (67%), kadar TIBC menurun berjumlah 35 pasien (75%), saturasi transferin normal berjumlah 26 pasien (54%), dan kadar feritin meningkat berjumlah 38 pasien (81%). Simpulan: Mayoritas pasien PGK stadium 5 yang menjalani hemodialisis reguler berusia 60-69 tahun, laki-laki dan perempuan berjumlah sama, serta memiliki kadar SI normal, penurunan TIBC, saturasi transferin normal, dan peningkatan kadar feritin. Kata kunci: serum iron, total iron binding capacity, saturasi transferin, feritin

scholarly journals Prevalence and associated risk factors of iron deficiency without anemia among school adolescents in Mbouda, Western Cameroon

2022 ◽  
Author(s):  
Odile Tadzong Mamokem ◽  
Wiliane Jean Takougoum Marbou ◽  
Marie Modestine Kana Sop ◽  
Bruno Phélix Telefo
Keyword(s):  
Risk Factors ◽  
Iron Deficiency ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
School Site ◽  
Mean Values ◽  
Significant Difference ◽  
Associated Risk Factors ◽  
Iron Binding Capacity

Background: Adolescents are a particularly vulnerable age group to iron deficiency without anemia (IDWA). This study aimed at determining the prevalence and associated risks factors of IDWA among apparently healthy school teenagers in Mbouda, West-Cameroon.Methods: The 778 blood samples were randomly collected from adolescents aged 10-19 years of four schools in Mbouda. Appropriate indicators including haemoglobin and haematocrit, serum iron, ferritin, transferrin, and total iron binding capacity, transferrin saturation were determined using standard methods.Results: The overall prevalence of IDWA was 40.4%. High significant difference in the mean values of serum iron (p≤0.001), serum ferritin (p≤0.001), TIBC (p=0.007), CST (p≤0.001) were observed in participants with IDWA compared to those without IDWA. The sociodemographic risk factors of IDWA in school adolescents were school site (p=0.022; 0.14 (0.90-1.43) and period of menstruation (p=0.015; 1.48 (1.083-2.03). Consumption of roots-tubers [OR: 0.92 (0.48-1.77)] legumes [OR: 2.65 (1.91-3.67)], cereals [OR: 0.90 (0.67-1.22)], increased the risk of IDWA while consumption of vegetables [OR: 0.29 (0.22-0.39)], eggs [OR: 0.66 (0.49-0.90)], and fish-shrimp [OR: 0.172 (0.10-0.295)] decreased the risk of IDWA. Meal consumption frequency had a statistically significant association with IDWA (p≤0.001).Conclusions: This study identified that IDWA was a major public health in adolescents. This study will help in planning and implementation of the policy for prevention of IDWA in adolescents.

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