Koya University, Faculty of Medicine, Lecturer at Department of Internal Medicine, Koya KOY45, Kurdistan Region F.R. Iraq.
Cell Mol Biol (Noisy-le-grand). 2024 Jul 28;70(7):115-121. doi: 10.14715/cmb/2024.70.7.16.
The most popular treatment for end-stage renal illness is hemodialysis (HD). The study aimed to assess serum ferritin levels and their connection to Epoetin alfa resistance, along with exploring the link between hepatitis C virus, iron overload, and the prevalence of hepatitis C and B infections in chronic HD patients. This was a descriptive-analytical study conducted on 50 Patients with chronic kidney disease (CKD) who were on regular HD in the dialysis unit of Ibin Sina Teaching Hospital in Mosul City, Iraq. Out of 50 patients, 26 (52%) tested positive for Hepatitis C Virus (HCV) Antibody, 10 (20%) for Hepatitis B surface Antigen (HBsAg), and 14 (28%) tested negative for both. Higher serum iron and ferritin levels were found in HCV antibody-positive patients (p < 0.05). Despite Epoetin alfa treatment, patients with elevated ferritin levels exhibited lower Hemoglobin (HB) and Packed Cell Volume (p < 0.05). Non-diabetics exhibited significantly higher serum ferritin, Hemoglobin, Blood urea, and serum creatinine than diabetics (p < 0.05). A noteworthy association was seen between the quantity of blood transfusions and elevated levels of serum ferritin and total serum iron (p < 0.05). Most HD patients were anemic, with Hepatitis B and C prevalent. The main CKD causes were diabetes and hypertension. HCV-positive patients often showed mild to moderate iron overload, and high serum ferritin was linked to poor Epoetin alfa response. Dialysis can elevate blood urea, ferritin, and creatinine, worsening anemia. High ferritin levels may hinder response to Epoetin alfa and iron replacement. Excessive blood transfusions can lead to iron overload and inhibit erythropoiesis. Maintaining HB at 110-120 g/l improves quality of life and reduces anemia-related risks.
对于终末期肾脏疾病，最常见的治疗方法是血液透析 (HD)。本研究旨在评估血清铁蛋白水平及其与促红细胞生成素抵抗的关系，并探讨丙型肝炎病毒、铁过载以及丙型和乙型肝炎病毒在慢性血液透析患者中的感染率之间的联系。这是一项在伊拉克摩苏尔市伊本西纳教学医院透析科接受常规血液透析的 50 名慢性肾脏病 (CKD) 患者中进行的描述性分析研究。在 50 名患者中，有 26 名（52%）丙型肝炎病毒 (HCV) 抗体阳性，10 名（20%）乙型肝炎表面抗原 (HBsAg) 阳性，14 名（28%）均为阴性。HCV 抗体阳性患者的血清铁和铁蛋白水平较高（p < 0.05）。尽管使用了促红细胞生成素治疗，但铁蛋白水平升高的患者血红蛋白 (HB) 和红细胞压积 (p < 0.05) 较低。非糖尿病患者的血清铁蛋白、血红蛋白、血尿素和血清肌酐水平明显高于糖尿病患者（p < 0.05）。输血量与血清铁蛋白和总血清铁水平升高之间存在显著相关性（p < 0.05）。大多数血液透析患者贫血，乙型和丙型肝炎病毒感染率较高。慢性肾脏病的主要病因是糖尿病和高血压。HCV 阳性患者常出现轻度至中度铁过载，且高血清铁蛋白与促红细胞生成素抵抗有关。透析会增加血尿素、铁蛋白和肌酐，从而加重贫血。高铁蛋白水平可能会阻碍促红细胞生成素和铁替代治疗的反应。过多的输血会导致铁过载并抑制红细胞生成。将 HB 维持在 110-120g/l 可提高生活质量并降低与贫血相关的风险。
