Abstract

BackgroundMost hemodialysis patients present with chronic systemic inflammation characterized by the elevation of serum C-reactive protein (CRP) levels and/or the production of proinflammatory interleukins by the immune system in response to the hemodialysis process. Plasma ferritin(PF) is one of the parameters used to correct anemia. An PF level of >500 ng/mL is not recommended for correction of anemia because of the uncertainty of whether these levels are elevated because of anemia or a mere reaction to inflammation. we aimed to study the effects of inflammation on seminal ferritin (SF) levels and hypothesized that SF is not affected because of the testicular immune privilege.MethodsA prospective prevalence study was conducted at the Department of Hemodialysis of the University Hospital of Brasília (HuB) between June 2010 and July 2011. The sample included 60 chronic renal patients undergoing hemodialysis and 20 control subjects from the health promotion general outpatient clinic. All participants were males aged 18–60 years. Inflammation was assessed through serum CRP levels, and the testicular condition was determined by measuring sex hormone levels. In the patient group, inflammation was considered to be present when CRP was >5 mg/L (n = 27) and absent when CRP was ≤5 mg/L (n = 33). Control group (n = 20) CRP was ≤1 mg/L. Blood and semen were collected via arm venoclysis and after voluntary masturbation, respectively. CRP was measured by turbidimetry; PF, SF, and sex hormone levels by immunochemoluminescence. Statistical significance was set at p < 0.05.ResultsThere was no significant difference in mean SF levels among patients with inflammation (295.34 ± 145.39 ng/mL), those without inflammation (324.42 ± 145.51 mg/mL), and controls (335.70 ± 075.90 ng/mL; p = 0.49). There was no correlation between mean SF and PF levels in the patients with and without inflammation). All participants were eugonadal with mean serum FSH, LH, and testosterone levels of 3.76 ± 2.17 mUI/mL, 7.00 ± 3.53 mUI/mL, and 454.18 ± 173.08 ng/dL, respectively.ConclusionSystemic inflammation did not significantly alter SF levels in eugonadal hemodialysis patients.

Highlights

  • Most hemodialysis patients present with chronic systemic inflammation characterized by the elevation of serum C-reactive protein (CRP) levels and/or the production of proinflammatory interleukins by the immune system in response to the hemodialysis process

  • The mean seminal ferritin (SF) levels according to the serum CRP levels were as follows: CRP > 5 mg/L (295.34 ± 145.39 ng/mL) vs CRP ≤ 5 mg/L (324.42 ± 145.51 ng/mL) vs CRP ≤ 1 mg/L (335.70 ± 075.90 ng/ mL) as per the Kruskal–Wallis test (p = 0.49)

  • There was no correlation between SF and plasma Ferritin (PF) levels in the patients with serum CRP > 5 mg/L and those with serum CRP ≤ 5 mg/L (p = 0.07 and p = 0.26, respectively, Pearson’s test)

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Summary

Introduction

Most hemodialysis patients present with chronic systemic inflammation characterized by the elevation of serum C-reactive protein (CRP) levels and/or the production of proinflammatory interleukins by the immune system in response to the hemodialysis process. Plasma ferritin(PF) is one of the parameters used to correct anemia. Ferritin (Fn) is an intracellular protein that stores iron in the atoxic form. It is present in most cells and is found in the extracellular environment as a result of cellular synthesis and secretion [1]. Plasma Ferritin (PF) is an important parameter for the correction of anemia, together with the transferrin saturation index and serum iron levels.

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