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EVALUATION OF HYPOPHEREMIA IN HEMODIALYSIS PATIENTS
AIDA ĆORIĆ
orcid.org/0000-0002-6994-1349
; Department of Hemodialysis, University of Sarajevo Clinical Center, Sarajevo, Bosnia and Herzegovina
ALMA MUTEVELIĆ TURKOVIĆ
; Department of Hemodialysis, University of Sarajevo Clinical Center, Sarajevo, Bosnia and Herzegovina
HALIMA RESIĆ
; Department of Hemodialysis, University of Sarajevo Clinical Center, Sarajevo, Bosnia and Herzegovina
AMINA VALJEVAC
orcid.org/0000-0001-9229-1631
; Department of Human Physiology, School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
NEJRA PROHIĆ
; Department of Hemodialysis, University of Sarajevo Clinical Center, Sarajevo, Bosnia and Herzegovina
AMELA BECIRAGIĆ
; Department of Hemodialysis, University of Sarajevo Clinical Center, Sarajevo, Bosnia and Herzegovina
SELMA AJANOVIĆ
; Department of Hemodialysis, University of Sarajevo Clinical Center, Sarajevo, Bosnia and Herzegovina
Abstract
Aim: The aim of this study was to evaluate the type of iron defi ciency in hemodialysis patients and compare their clinical, hematological and infl ammatory parameters according to this type of defi ciency. Material and methods: The study included 100 chronic hemodialysis patients with their demographic and clinical characteristics, and analyzed for their complete blood count, erythropoietin level, iron, total iron binding capacity (TIBC), unsaturated iron binding capacity (UIBC), iron saturation, transferrin, ferritin, C-reactive protein (CRP) and hepcidin. Results: Absolute iron defi ciency was found in 10%, functional defi ciency in 2% and reticuloendothelial blockade in 2% of patients, while 86% of them had no iron defi ciency. Examining clinical, hematologic and infl ammatory parameters in patients on hemodialysis in relation to the type of iron defi ciency, it was found that patients with absolute iron defi ciency had signifi cantly shorter duration of hemodialysis, length of erythropoietin therapy, signifi cantly lower iron, ferritin and signifi cantly lower saturation index values compared to patients without iron defi ciency. Erythropoietin levels were low in 15% and high in 29% of patients. The study showed that anemia was present in 96% of patients receiving therapy for anemia, 90% received iron supplements; all of 100 patients received folic acid, 80% of patients received erythropoietin. Patients on hemodialysis had elevated hepcidin values up to 72%, which is expected in hemodialysis population, given the reduced renal clearance and a quarter of patients with infl ammation, and proven CRP and hepcidin positive correlation. Conclusion: Patients with absolute iron defi ciency should initially receive iron supplements in therapy, compared to erythropoietin for a more adequate response and better correction of anemia. Patients with functional iron defi ciency receive maintenance doses of iron preparations, while patients with infl ammation may have lower ferritin values and falsely low iron depots until the infl ammatory parameters are corrected.
Keywords
absolute and functional iron deficiency; erythropoietin; ferritin; inflammation; hepcidin
Hrčak ID:
294426
URI
Publication date:
27.2.2023.
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