THE EFFECT OF LACTOFERRIN ON HEMOGLOBIN, ERYTHROFERRONE AND HEPCIDIN LEVELS IN CHRONIC KIDNEY DISEASE

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Abstract Title

First Name *

Madhuri

Last Name *

Kashyap

Co-author 1

Kushal Kekan kekankushal@gmail.com PGIMER Nephrology Chandigarh

Co-author 2

Smita Divyaveer divyaveer.ss@gmail.com PGIMER Nephrology Chandigarh

Co-author 3

Madhuri Kashyap madhurikashyap27@gmail.com PGIMER Nephrology Chandigarh

Co-author 4

Kanchan Prajapati kanchankumari93369@gmail.com PGIMER Nephrology Chandigarh

Co-author 5

Madhumita Premkumar drmadhumitap@gmail.com PGIMER Hepatology Chandigarh

Co-author 6

Deepy Zohmangaihi drdeepyz14@gmail.com PGIMER Biochemistry Chandigarh

Co-author 7

Nabhajit Mallik nabs.mallik@gmail.com PGIMER Hematology Chandigarh

Co-author 8

Ashok Kumar Yadav mails2ashok@gmail.com PGIMER Experimental Medicine & Biotechnology Chandigarh

Co-author 9

Aakanksha Sharma dr.aakanksha93@gmail.com PGIMER Nephrology Chandigarh

Co-author 10

Arun Prabhahar arunprabhaharcmc@gmail.com PGIMER Nephrology Chandigarh

Co-author 11

Sahil Garg mbbs.sahil121@yahoo.com PGIMER Nephrology Chandigarh

Co-author 12

Gowri Shankar S s.gowri.shank@gmail.com PGIMER Nephrology Chandigarh

Co-author 13

Imran Rather ratherimraan@gmail.com PGIMER Pharmacology Chandigarh

Co-author 14

Harbir Singh Kohli kohlihs2009@gmail.com PGIMER Nephrology Chandigarh

Co-author 15

Introduction

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.

Methods

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.

Results

Conclusions

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.

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