Do Transferrin Levels Predict Haemodialysis Adequacy in Patients with End-Stage Renal Disease?

被引:7
作者
Tarantino, Giovanni [1 ]
Vinciguerra, Mauro [2 ]
Ragosta, Annalisa [3 ]
Citro, Vincenzo [4 ]
Conforti, Paolo [5 ]
Salvati, Giovanni [3 ]
Sorrentino, Aniello [6 ]
Barretta, Luca [6 ]
Balsano, Clara [7 ]
Capone, Domenico [8 ]
机构
[1] Univ Naples Federico II, Med Sch Naples, Dept Clin Med & Surg, I-80131 Naples, Italy
[2] Santa Maria Delle Grazie Hosp, Nephrol Sect, I-80078 Pozzuoli, Italy
[3] Dial Ctr Srl, Outpatients Clin Hemohaemodialysis, I-80038 Naples, Italy
[4] Umberto I Hosp, Dept Gen Med, I-84014 Salerno, Italy
[5] Univ Naples Federico II, Med Sch Naples, I-80131 Naples, Italy
[6] Diagnost Ctr Kappa Srl, I-80038 Naples, Italy
[7] Univ Aquila, Dept Clin Med Life Hlth & Environm Sci MESVA, I-67100 Laquila, Italy
[8] Univ Naples Federico II, Sect Med Pharmacol & Toxicol, Integrated Care Dept Publ Hlth & Drug Use, I-80131 Naples, Italy
关键词
nutritional status; inflammation; iron status; haemodialysis adequacy; NUTRITIONAL RISK INDEX; DIALYSIS PATIENTS; MORTALITY; IRON; MALNUTRITION; INFLAMMATION; FAILURE; KT/V; HEPCIDIN;
D O I
10.3390/nu11051123
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: Since haemodialysis is a lifesaving therapy, adequate control measures are necessary to evaluate its adequacy and to constantly adjust the dose to reduce hospitalisation and prolong patient survival. Malnutrition is common in haemodialysis patients and closely related to morbidity and mortality. Patients undergoing haemodialysis have a high prevalence of protein-energy malnutrition and inflammation, along with abnormal iron status. The haemodialysis dose delivered is an important predictor of patient outcome. Aim: To evaluate through haemodialysis adequacy, which parameter(s), if any, better predict Kt/V, among those used to assess nutritional status, inflammation response, and iron status. Methods: We retrospectively studied 78 patients undergoing haemodialysis due to end-stage renal disease. As parameters of nutritional status, geriatric nutritional risk index (GNRI), transferrin levels, lymphocyte count, and albumin concentration were analysed. As signs of inflammation, C reactive protein (CRP) levels and ferritin concentrations were studied as well. Iron status was evaluated by both transferrin and ferritin levels, as well as by haemoglobin (Hb) concentration. Results: The core finding of our retrospective study is that transferrin levels predict the adequacy of haemodialysis expressed as Kt/V; the latter is the only predictor (P = 0.001) when adjusting for CRP concentrations, a solid marker of inflammation, and for ferritin levels considered an iron-storage protein, but also a parameter of inflammatory response. Discussion and Conclusion: In keeping with the results of this study, we underline that the use of transferrin levels to assess haemodialysis quality combine into a single test the evaluation of the three most important factors of protein-energy wasting.
引用
收藏
页数:11
相关论文
共 30 条
  • [11] Iron deficiency and heart failure: diagnostic dilemmas and therapeutic perspectives
    Jankowska, Ewa A.
    von Haehling, Stephan
    Anker, Stefan D.
    Macdougall, Iain C.
    Ponikowski, Piotr
    [J]. EUROPEAN HEART JOURNAL, 2013, 34 (11) : 816 - 826
  • [12] Inflammation and Protein-Energy Wasting in the Uremic Milieu
    Jankowska, Magdalena
    Cobo, Gabriela
    Lindholm, Bengt
    Stenvinkel, Peter
    [J]. EXPANDED HEMODIALYSIS: INNOVATIVE CLINICAL APPROACH IN DIALYSIS, 2017, 191 : 58 - 71
  • [13] Inflammatory syndrome in patients on hemodialysis
    Jofre, Rosa
    Rodriguez-Benitez, Patrocinio
    Lopez-Gomez, Juan M.
    Perez-Garcia, Rafael
    [J]. JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2006, 17 : S274 - S280
  • [14] Total iron-binding capacity-estimated transferrin correlates with the nutritional subjective global assessment in hemodialysis patients
    Kalantar-Zadeh, K
    Kleiner, M
    Dunne, E
    Ahern, K
    Nelson, M
    Koslowe, R
    Luft, FC
    [J]. AMERICAN JOURNAL OF KIDNEY DISEASES, 1998, 31 (02) : 263 - 272
  • [15] A low serum iron level is a predictor of poor outcome in hemodialysis patients
    Kalantar-Zadeh, K
    McAllister, CJ
    Lehn, RS
    Kopple, JD
    [J]. AMERICAN JOURNAL OF KIDNEY DISEASES, 2004, 43 (04) : 671 - 684
  • [16] Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences
    Kalantar-Zadeh, K
    Ikizler, TA
    Block, G
    Avram, MM
    Kopple, JD
    [J]. AMERICAN JOURNAL OF KIDNEY DISEASES, 2003, 42 (05) : 864 - 881
  • [17] GERIATRIC NUTRITIONAL RISK INDEX AS A PROGNOSTIC FACTOR IN PERITONEAL DIALYSIS PATIENTS
    Kang, Seok Hui
    Cho, Kyu Hyang
    Park, Jong Won
    Yoon, Kyung Woo
    Do, Jun Young
    [J]. PERITONEAL DIALYSIS INTERNATIONAL, 2013, 33 (04): : 405 - 410
  • [18] Ferritin Is a Marker of Inflammation rather than Iron Deficiency in Overweight and Obese People
    Khan, Abidullah
    Khan, Wazir Muhammad
    Ayub, Maimoona
    Humayun, Mohammad
    Haroon, Mohammad
    [J]. JOURNAL OF OBESITY, 2016, 2016
  • [19] Kuwae N, 2005, CLIN NEPHROL, V63, P22
  • [20] Hs-CRP and all-cause, cardiovascular, and cancer mortality risk: A meta-analysis
    Li, Yunwei
    Zhong, Xiaoming
    Cheng, Guanchang
    Zhao, Cuihua
    Zhang, Lei
    Hong, Yan
    Wan, Qilin
    He, Ruili
    Wang, Zhizhong
    [J]. ATHEROSCLEROSIS, 2017, 259 : 75 - 82