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Anemia continues to be a common complication in chronic kidney disease (CKD) population despite optimum treatment with adequate dialysis, erythropoietin and repletion of nutrient deficiencies. As shown via our other abstract presented at WCN 2024, lactoferrin has anti-inflammatory properties and plays a major role in improvement of hemoglobin, absorption and utilization of iron. Erythroferrone is a hormone that is increased as the body’s response to anemia and improves hemoglobin (Hb) levels. Among other mechanisms for improving erythropoiesis, the most putative mechanism of erythroferrone is by decreasing hepcidin. In this study we aim to analyse the effect of Lactoferrin on Hb, erythroferrone and hepcidin levels. CTRI number of the project is CTRI/2020/04/024746.
This is a single arm study wherein CKD patients with anemia were screened at the in-patient and out-patient service. 40 patients with T.Sat> 20 mg/dL, Hb< 10 g/dL, stable creatinine for 3 months, stable erythropoietin dose, no new addition of hematinics in last 3 months were enrolled and were treated with lactoferrin for 1 month (100mg, twice daily). 37 % of the patients were on oral liposomal iron treatment (tablets (30 mg once daily). Patients with hematological diseases, malignancy and chronic infection, receiving systemic immunosuppressive therapy at presentation were excluded from study. Clinical and laboratory characteristics of the hematology profile, RFT, iron profile, inflammatory markers ESR and CRP were recorded at baseline and 1 month follow-up. Plasma samples were stored at baseline and 1 month follow-up for analyzing erythroferrone and hepcidin by ELISA technique. Statistical analysis was done using two tailed paired t-test.
In CKD patients with anemia, Lactoferrin treatment showed improvement in Hb and/ with decrease in erythroferrone. However, change in hepcidin was not significantly different. Larger and longer follow ups are needed for further studies. Alongside, it will be beneficial to study if the effect of Lactoferrin is more in patients on iron treatment.