Kekan Kushal, Divyaveer Smita, Kashyap Madhuri, Premkumar Madhumita, Zohmangaihi Deepy, Mallik Nabhajit, Lad Deepesh, Sharma Akanksha, Shankar S Gowri, Garg Sahil, Prabhahar Arun, Chaudhary Ankur, Suleiman Shabna, Rather Imran, Verma Manish, Jassal Ravjit Singh, Kohli Harbir Singh
Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Nephrol. 2024 May-Jun;34(3):222-227. doi: 10.4103/ijn.ijn_13_23. Epub 2023 Oct 23.
Anemia occurs in majority of patients with chronic kidney disease despite adequate dialysis and iron replete status. This study was done to evaluate the effects of lactoferrin with or without iron supplementation for the treatment of anemia in patients with chronic kidney disease (CKD).
In this prospective, observational, single-center, single-arm pilot study, adult patients aged >18 years, having stage 5 CKD (estimated glomerular filtration rate [eGFR] <15 ml/min/1.73 m), and who had anemia (hemoglobin [Hb] <10 g/dl; transferrin saturation [T] >20%) were included. Patients were treated with 100 mg of oral lactoferrin twice a day for one month with or without iron supplementation. Patients had been on stable erythropoietin doses for ≥1 month prior to inclusion in the study. We report on the improvement in Hb levels and effect on inflammatory markers from baseline at four weeks.
A total of 46 CKD patients having anemia were included. Patients had a mean age of 39.3 years, and a majority were men (69.6%). Improvement in the mean (SD) Hb level (g/dl) was observed from baseline (8.18 [1.19]) to Week 2 (8.54 [1.57]), which attained significance at Week 4 (8.96 [1.93]; < 0.001; mean difference: -0.76; 95% confidence interval [CI]: -1.291 to - 0.2383). The improvement in Hb was higher in women than in men ( = 0.48) and in patients receiving lactoferrin with iron supplementation than in those receiving lactoferrin alone ( = 0.14). There was a non-significant decrease in the erythrocyte sedimentation rate ( = 0.14) and a non-significant increase in C-reactive protein ( = 0.54) level.
Oral lactoferrin therapy was effective in improving hemoglobin levels in patients with advanced CKD and anemia. The effects of lactoferrin therapy on inflammatory markers remain uncertain.
尽管进行了充分透析且铁储备充足，但大多数慢性肾脏病患者仍会出现贫血。本研究旨在评估补充或不补充铁的乳铁蛋白对慢性肾脏病（CKD）患者贫血治疗的效果。
在这项前瞻性、观察性、单中心、单臂试点研究中，纳入了年龄大于18岁、患有5期CKD（估计肾小球滤过率[eGFR]<15 ml/min/1.73 m²）且患有贫血（血红蛋白[Hb]<10 g/dl；转铁蛋白饱和度[T]>20%）的成年患者。患者接受每日两次100 mg口服乳铁蛋白治疗，为期1个月，同时补充或不补充铁剂。在纳入研究前，患者已接受稳定剂量的促红细胞生成素治疗≥1个月。我们报告了四周时血红蛋白水平的改善情况以及对炎症标志物相对于基线水平的影响。
共纳入46例患有贫血的CKD患者。患者的平均年龄为39.3岁，大多数为男性（69.6%）。观察到平均（标准差）血红蛋白水平（g/dl）从基线时的（8.18[1.19]）改善至第2周时的（8.54[1.57]），并在第4周时达到显著水平（8.96[1.93]；P<0.001；平均差值：-0.76；95%置信区间[CI]：-1.291至-0.2383）。女性血红蛋白的改善高于男性（P = 0.48），补充铁剂的乳铁蛋白治疗患者高于仅接受乳铁蛋白治疗的患者（P = 0.14）。红细胞沉降率有非显著性下降（P = 0.14），C反应蛋白水平有非显著性升高（P = 0.54）。
口服乳铁蛋白治疗对晚期CKD和贫血患者提高血红蛋白水平有效。乳铁蛋白治疗对炎症标志物的影响仍不确定。
