BACKGROUND: An iron deficiency is often present in haemodialysis (HD) patients; however, although transferrin saturation (TSAT) of <20% and/or serum ferritin of <200 ng/mL should express iron scarcity, in HD patients high ferritin levels could be related to inflammation rather than reflecting optimal iron stores. METHODS: The aim of the present study was to evaluate serum levels of neutrophil gelatinase-associated lipocalin (NGAL), a small siderophore-binding protein, in a cohort of 56 chronic HD patients in order to determine its possible relationships with iron status. RESULTS: NGAL levels were markedly higher in HD patients than in healthy controls; furthermore, HD patients with TSAT <20% had lower NGAL values than healthy controls, whereas the correction of iron deficiency by means of chronic i.v. iron administration significantly increased NGAL values from baseline. Findings from univariate and multivariate analyses demonstrated that NGAL was a significant predictor of hsCRP, spKT/V and TSAT. In ROC analysis, a NGAL cut-off level of <or=473 ng/mL had a greater sensitivity and specificity than a ferritin level of <200 ng/mL in identifying iron deficiency among HD patients. CONCLUSIONS: The findings demonstrated that HD patients have altered NGAL values probably because this protein is involved in the maintenance of iron equilibrium. Finally, NGAL might be proposed as a new tool in the assessment of iron deficiency and in the management of iron therapy for HD patients.
BACKGROUND: An iron deficiency is often present in haemodialysis (HD) patients; however, although transferrin saturation (TSAT) of <20% and/or serum ferritin of <200 ng/mL should express iron scarcity, in HDpatients high ferritin levels could be related to inflammation rather than reflecting optimal iron stores. METHODS: The aim of the present study was to evaluate serum levels of neutrophil gelatinase-associated lipocalin (NGAL), a small siderophore-binding protein, in a cohort of 56 chronic HDpatients in order to determine its possible relationships with iron status. RESULTS:NGAL levels were markedly higher in HDpatients than in healthy controls; furthermore, HDpatients with TSAT <20% had lower NGAL values than healthy controls, whereas the correction of iron deficiency by means of chronic i.v. iron administration significantly increased NGAL values from baseline. Findings from univariate and multivariate analyses demonstrated that NGAL was a significant predictor of hsCRP, spKT/V and TSAT. In ROC analysis, a NGAL cut-off level of <or=473 ng/mL had a greater sensitivity and specificity than a ferritin level of <200 ng/mL in identifying iron deficiency among HDpatients. CONCLUSIONS: The findings demonstrated that HDpatients have altered NGAL values probably because this protein is involved in the maintenance of iron equilibrium. Finally, NGAL might be proposed as a new tool in the assessment of iron deficiency and in the management of iron therapy for HDpatients.
Authors: Il Young Kim; Joo Hui Kim; Dong Won Lee; Soo Bong Lee; Harin Rhee; Sang Heon Song; Eun Young Seong; Ihm Soo Kwak Journal: Clin Exp Nephrol Date: 2017-04-07 Impact factor: 2.801
Authors: Philipp Kümpers; Carsten Hafer; Alexander Lukasz; Ralf Lichtinghagen; Korbinian Brand; Danilo Fliser; Robert Faulhaber-Walter; Jan T Kielstein Journal: Crit Care Date: 2010-02-01 Impact factor: 9.097
Authors: Paolo Fanti; Daniela Giustarini; Ranieri Rossi; Sue E D Cunningham; Franco Folli; Khaled Khazim; John Cornell; Elena Matteucci; Shweta Bansal Journal: J Ren Nutr Date: 2015-07-31 Impact factor: 3.655
Authors: Pierina De Muro; Antonio Junior Lepedda; Gabriele Nieddu; Michela Idini; Hai Quy Tram Nguyen; Omar Lobina; Pietro Fresu; Marilena Formato Journal: Biochem Res Int Date: 2016-01-24