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Dr. Omima Mohamed abd el haie :: Publications:

Title:
Vitamin d supplementation explodes the triangle of danger "iron deficiency anemia, inflammation and hypovitaminosis D" in pediatric patients on hemodialysis
Authors: 1Soha Abdelhady Ibrahim, 2Eman Ramadan Abdel Gawad, 3Omima Mohamed Abdel Haie, 4Amira Ibrahim Mansour, 5Akram Elshafey Elsadek
Year: 2016
Keywords: Chronic kidney disease, Vitamin D therapy, Iron deficiency anemias
Journal: Journal of Medicine and Medical Sciences
Volume: 7
Issue: 2
Pages: Not Available
Publisher: Not Available
Local/International: International
Paper Link: Not Available
Full paper Omima Mohamed abd el haie_vitamin d supplementation explodes the triangle of danger iron deficiency anemia inflammation and hypovitaminosis d in pediatric patients on hemodialysis (2).pdf
Supplementary materials Not Available
Abstract:

Vitamin D deficiency is extremely frequent in chronic kidney disease (CKD) and is associated with erythropoietin hypo-responsiveness. Hepcidin, the primary regulator of iron homeostasis, may play a critical role in the response of patients with anemia to iron and erythropoiesis-stimulating agent therapy; however, the participation of hepcidin to anemia in hemodialysis (HD) patients had not been completely characterized. To evaluate the relationship between serum hepcidin, indicators of anemia, iron status, inflammation and 25-hydroxy vitamin D (25-OH D) levels in children with CKD on HD and the impact of vitamin D therapy on these parameters. This analytical case-control, a double-center study was carried out on CKD patients attending the Nephrology Unit of the pediatric department at Benha and El Menofeya University Hospitals. Participants were classified into two groups: Group I Forty patients with end-stage kidney disease (ESKD) on HD. Group II Thirty healthy children of matched age and sex were included as a control group. All participants were subjected to full medical history, thorough clinical examination and laboratory evaluation in the form of complete blood count (CBC), kidney functions, liver functions, IL-6, serum levels of iron, ferritin, hepcidin and 25-OH D levels by ELISA. All patients received ergocalciferol as intensive replacement therapy depending on baseline 25-OH D levels for 3 months followed by maintenance therapy. Pre-treatment levels of study parameters were significantly disturbed compared to control measures. Hepcidin was significantly increased in pediatric HD patients (272.7±152.6 ng/ml) when compared with their respective control subjects (39.1±21.8 ng/ml). A significant positive correlation was demonstrated between serum hepcidin levels and both IL-6 and serum ferritin, while a significant negative correlation was revealed between serum hepcidin and, Hb, serum 25-OH D and iron. Post-treatment with ergocalciferol, the serum ferritin, hepcidin and IL-6 levels were significantly decreased, while Hb level and Hct value were significantly increased compared to pretreatment levels. These findings suggest that hepcidin may mediate the negative effects on both disordered iron metabolism and erythropoiesis in HD patients and that Ergocalciferol could be used therapeutically to reduce hepcidin concentrations and thereby improve erythropoiesis-stimulating agent responsiveness and reduce inflammatory mediators.

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