Study the Effect and Safety of Oral Lactoferrin Therapy for Functional Iron Deficiency Anemia in Prevalent Hemodialysis Patients

Abstract

Abstract Background Anemia is one of the main problems in hemodialysis patients, which is caused by inadequate production of erythropoietin. Functional iron deficiency (FID) anemia is a kind of anemia, which lack of functional iron therein leads to resistance and inappropriate response to erythropoietin in hemodialysis patients. Aim of the Work The aim of the present study was to study the effect and safety of oral lactoferrin therapy for functional iron deficiency anemia in prevalent hemodialysis patients. Patients and Methods This was Randomized clinical trial, was conducted at El Demerdash hemodialysis unit on 70 prevalent hemodialysis patients divided into 2 groups: (Group A): included 35 patients with functional iron deficiency anemia, received lactoferrin together with the recommended dose of ESA therapy for 3 months, (Group B): included 35 patients with functional iron deficiency anemia, received no lactoferrin apart from the recommended dose of ESA therapy for 3 months. Results There was no statistically significant difference between the two studied groups (group A and group B) as regard sex, occupation, residence and age. There was no statistically significant difference between the two studied groups (group A and group B) as regard height, weight and BMI. There was no statistically significant difference between the two studied groups (group A and group B) as regard history. There was no statistically significant difference between the two studied groups (group A and group B) as regard hemoglobin and WBCs. There was no statistically significant difference between the two studied groups (group A and group B) as regard PLT and Reticulocyte %. There was no statistically significant difference between the two studied groups (group A and group B) as regard ferritin, serum iron and TSAT. There was highly statistically significant difference between the two studied groups (group A and group B) as regard KT/V and URR at 3 months. There was nostatistically significant difference between the two studied groups (group A and group B) as regard KT/V and URR at baseline. Conclusion Oral lactoferrin could not be used as a substitute to totally replace IV ferrous sulphate in treating iron deficiency anemia in end stage renal disease (ESRD) on dialysis. Oral lactoferrin could not even control Hb level constant without dropping in patients with end stage renal disease (ESRD). Oral lactoferrin had some gastrointestinal effects on some patients which did not allow compliance on the medication.