Serum Hb Levels Research Articles

Analysis of Influencing Factors of Moderate to Severe Malnutrition in Elderly Patients with Lung Cancer during Chemotherapy

Objective: This study aims to identify the factors influencing moderate to severe malnutrition in elderly lung cancer patients undergoing chemotherapy and to provide a basis for developing clinical prevention and intervention strategies. Methods: The clinical data of 150 elderly lung cancer patients who received chemotherapy were retrospectively analyzed. Demographic data, clinical characteristics, laboratory indicators, treatment plans, and other relevant information were collected. Independent risk factors for moderate to severe malnutrition during chemotherapy were identified. Results: During chemotherapy, 50 patients (33.33%) developed moderate to severe malnutrition. The BMI of patients with moderate to severe malnutrition was significantly lower than that of patients with no or mild malnutrition (21.20 ± 1.60 vs. 26.14 ± 2.31, P < 0.001), and the proportion of patients with stage IV tumors was significantly higher (60.00% vs. 27.00%, P < 0.001). Serum pre-albumin (pre-ALB) and hemoglobin (Hb) levels in patients with moderate to severe malnutrition were significantly lower than those in patients with no or mild malnutrition (152.67 ± 30.41 g/L vs. 252.47 ± 51.24 g/L and 102.44 ± 10.09 g/L vs. 154.21 ± 15.18 g/L, respectively, P < 0.001 for all). Conclusion: Low BMI, decreased serum pre-ALB levels, and decreased serum Hb levels before chemotherapy are independent risk factors for moderate to severe malnutrition in elderly lung cancer patients during chemotherapy. Close clinical attention should be given to these patients, with early intervention measures such as nutritional support to reduce the incidence of malnutrition and improve patients’ quality of life and prognosis.

Assessing anorectal function in patients with recurrent ulcerative colitis

PurposeUlcerative colitis (UC) is an inflammatory bowel disease with an unclear etiology that can lead to irreversible changes in distal colonic function in chronic patients. This study investigated anorectal function in recurrent UC patients and identified influencing factors.MethodsThis prospective study enrolled 33 recurrent UC patients and 40 newly diagnosed patients from January 2019 to December 2022. Data collection included clinical records, scores, and anorectal function assessments. Regression analyses were used to identify factors impacting anorectal function.ResultsRecurrent UC patients had higher baseline CRP and fecal calprotectin levels, increased anxiety and depression, and more severe fecal incontinence. They also had lower BMIs, serum Hb and albumin (ALB) levels, and Inflammatory Bowel Disease Questionnaire scores than did initial-onset UC patients. Multivariate linear regression analysis revealed that long disease duration (coef. − 0.376, P < 0.001) and high fecal calprotectin level (coef. − 0.656, P < 0.001) independently influenced the initial sensation threshold in recurrent UC patients. Additionally, high fecal calprotectin (coef. − 0.073, P = 0.013) and high Zung Self-Rating Anxiety Scale score (coef. − 0.489, P = 0.001) were identified as two independent determinants of the defecation volume threshold. For the defecation urgency threshold, the independent factors included high disease duration (coef. − 0.358, P = 0.017) and high fecal calprotectin level (coef. − 0.499, P = 0.001). Similarly, the sole independent factor identified for the maximum capacity threshold was high fecal calprotectin (coef. − 0.691, P = 0.001).ConclusionRecurrent UC patients had increased rectal sensitivity and compromised anorectal function, which significantly impacted quality of life. Proactively managing the disease, reducing UC relapses, and addressing anxiety are effective measures for improving anorectal function in these patients.

Hemoglobin levels and cognitive trajectory: unveiling prognostic insights in post-stroke geriatric cohort

PurposeEvidence is scarce regarding the association between anemia and alterations in cognitive level among hospitalized older patients. We aimed to evaluate the associations between baseline hemoglobin (Hb) levels and changes in cognitive level in patients undergoing rehabilitation after stroke. MethodsA retrospective cohort study was conducted, encompassing consecutively hospitalized post-stroke patients. Data on serum Hb levels were extracted from medical records, specifically tests conducted within 24 hours of admission. Primary outcomes included discharge scores for cognitive function assessed by the cognitive domain of the Functional Independence Measure (FIM-cognition) and the corresponding change in FIM-cognition during hospitalization. Another outcome measure was the length of hospital stay. Multivariate linear regression analyses were employed to assess the association between Hb levels at admission and the designated outcomes, adjusting for potential confounding factors. ResultsData from 955 patients (mean age 73.2 years; 53.6% men) were included in the analysis. The median Hb level at admission was 13.3 [11.9, 14.5] g/dL. After fully adjusting for confounding factors, the baseline Hb level was significantly and positively associated with FIM-cognition at discharge (β = 0.045, p = 0.025) and its gain (β = 0.073, p = 0.025). Further, the baseline Hb level was independently and negatively associated with length of hospital stay (β = -0.013, p = 0.026). ConclusionElevated baseline Hb levels are correlated with preserved cognitive level and shorter hospital stays in post-stroke patients. Evaluating anemia at the outset serves as a crucial prognostic indicator.

Childhood asthma biomarkers including zinc: An exploratory cross-sectional study.

Childhood bronchial asthma (BA) is a chronic inflammatory respiratory disease. Nutritional conditions, including zinc deficiency, can affect such allergic disorders. To outline the difference in serum zinc levels between asthmatic children and healthy controls. A cross-sectional study was carried out at Children's Hospital, Cairo University, investigating serum zinc levels in children with BA (n = 40) and healthy children (n = 21). Other markers included serum ferritin, iron, hemoglobin (Hb), and immunoglobulin E (IgE) levels. Independent t-tests and Mann-Whinny tests were used for comparisons. The Kruskal-Wallis test was applied to compare serum ferritin and IgE levels with regard to asthma severity. Spearman's rank correlation was performed to explore the relationship between serum ferritin levels and both iron and Hb levels in asthmatic children. Children with BA had higher levels of zinc, yet the difference was not significant (P = 0.115). Serum ferritin and IgE levels were significantly higher in asthmatic children (P = 0.006 and 0.001, respectively), yet their levels did not differ significantly by severity (P = 0.623 and 0.126, respectively). There was a nonsignificant weak correlation between serum ferritin levels and both serum iron and Hb levels. Serum zinc levels do not seem to differ between asthmatic children and healthy children. Serum ferritin levels may be a marker of asthma control. Serum IgE levels are not markers of asthma severity.

Therapeutic effect of ferrous sulfate in diabetic patients with iron deficiency anaemia: a randomised controlled trial.

Iron deficiency anaemia (IDA) and diabetes mellitus (DM) are most prevalent disease, that diabetic patients are more prone to IDA. Therefore, the main aim of this study was to investigate the relationship between patients with diabetes and IDA in relation to taking iron pills daily and every other day to reduce the effects related to it. Ninety-one participants were enroled and randomly divided into two groups, with a final analysis cohort of 72 patients. The primary focus was on changes in serum Hb and Ferritin levels. The screening phase lasted 24 weeks, leading to 72 eligible participants meeting the criteria for entry into the study. Additionally, the study examined alternations in Hb and Hb A1C levels after treating patients with iron deficiency. The Hb and ferritin level contrasts between groups were not significant (P = 0.096 and P = 0.500, respectively). The relationship between Hb A1C and Hb levels before and after treatment was positive and significant (r 2 = 0.187). The results of the present study show that although the effectiveness of using oral iron supplements did not have a significant difference in terms of increasing haemoglobin and ferritin, the use of oral iron once every other day was more effective than the use of oral iron every day, and also in this study Like other studies, this result concluded that there is a negative correlation between Hb A1C and Hb, and to check the status of Hb A1C in diabetics, the level of Hb should be considered first.

Reducing the need for colonoscopy with adjusted FIT and FOBT for stool weight and serum Hb levels.

Reducing the need for colonoscopy with adjusted FIT and FOBT for stool weight and serum Hb levels.

Association between serum phosphate levels and anemia in non-dialysis patients with chronic kidney disease: a retrospective cross-sectional study from the Fuji City CKD Network

BackgroundPatients with chronic kidney disease (CKD) present high mortality and morbidity rates despite the availability of various therapies. Although CKD-mineral and bone disorder (MBD) and renal anemia are important factors in patients with CKD, only few studies have analyzed the relationship between them. Therefore, this study aimed to evaluate the relationship between CKD-MBD and anemia in patients with CKD who did not receive erythropoiesis-stimulating agent or iron therapies.MethodsThis retrospective cross-sectional study included patients with CKD aged ≥ 20 years with estimated glomerular filtration rate (eGFR) categories G2a to G5 who were referred to the Fuji City General Hospital between April 2018 and July 2019. The exclusion criterion was ongoing treatment for CKD-MBD and/or anemia.ResultsThe data of 300 patients with CKD were analyzed in this study. The median age of patients was 71 (range, 56.5–79) years. The median eGFR was 34 (range, 20–48) mL/min/1.73 m2, and the mean hemoglobin (Hb) level was 12.7 g/dL (standard deviation, 2.3), which decreased as the CKD stage increased. In a multivariate linear regression analysis of anemia-related factors, including age, renal function (eGFR), nutritional status, inflammation, and iron dynamics (serum iron level, total iron-binding capacity, ferritin levels), the serum phosphate levels were significantly associated with the Hb levels (coefficient [95% confidence interval], -0.73 [-1.1, -0.35]; P < 0.001). Subgroup analysis revealed a robust association between serum phosphate levels and Hb levels in the low-ferritin (coefficient [95% confidence interval], -0.94 [-1.53, -0.35]; P = 0.002) and advanced CKD groups (coefficient [95% confidence interval], -0.89 [-1.37, -0.41]; P < 0.001).ConclusionsWe found an association between high serum phosphate levels and low Hb levels in patients with CKD not receiving treatment for anemia. These results underscore the possibility of a mechanistic overlap between CKD-MBD and anemia.

An Overview of Safety and Efficacy Between Hypoxia-Inducible Factor-Prolyl-Hydroxylase Inhibitors and Erythropoietin-Stimulating Agents in Treating Anemia in Chronic Kidney Disease Patients.

Anemia is one of the common complications in chronic kidney disease (CKD) patients. Erythropoietin and iron deficiencies are the major causes to develop anemia in CKD patients. Untreated anemia is associated with increased morbidity and mortality. Erythropoietin-stimulating agents (ESA) with iron supplementation are the standard for treating renal anemia. Although ESA with iron supplementation is an effective therapy in maintaining serum hemoglobin (Hb) levels, it increases the risk of several life-threatening adverse events such as hypertension, thromboembolism, cardiovascular morbidity, and mortality with long-term use. Therefore, effective alternate therapy with better safety and efficacy is needed to treat renal anemia. The newer oral therapy hypoxia-inducible factor-prolyl-hydroxylase inhibitors (HIF-PHI) can potentially be an effective alternative therapy in treating renal anemia. This review article compares the safety and efficacy between HIF-PHI and ESA in treating anemia in CKD patients. We conducted a comprehensive literature review of articles, including clinical trials, meta-analyses, and reviews, that compared the safety and efficacy between HIF-PHI and ESA. Studies have shown that the newer oral therapy, HIF-PHI, was non-inferior to ESA to maintain serum Hb levels in CKD patients. Moreover, the adverse event profile was almost similar in both groups. However, as the studies we reviewed have small sample sizes and short duration periods, the long-term effectiveness and safety of HIF-PHI over ESA in treating renal anemia cannot be established.

Iron-deficiency anemia in relation to body mass index among Iraqi primigravida women.

Anemia affects approximately half a billion women of reproductive age worldwide, with 31% of pregnant women in Iraq aged 15-49 years experiencing anemia. This condition is associated with increased risks of maternal and fetal morbidity and mortality, including stillbirths, miscarriages, prematurity, and low birth weight. This study investigated the correlation between iron-deficiency anemia (IDA) and body mass index (BMI) among primigravidae in Iraq. One hundred primiparous women in their third trimester were recruited from Baghdad Medical City Teaching Hospital and Teaching Hospital of Obstetrics and Gynecology in Karbala. Participants were categorized into four groups based on BMI: underweight (BMI < 18.5 kg/m^2), normal weight (BMI 18.5-24.9 kg/m^2), overweight (BMI 25-29.9 kg/m^2), and obese (BMI ≥ 30 kg/m^2). Demographic and medical history data were collected from the participants, and hematological investigations were conducted to measure hemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), and serum ferritin levels. Statistical significance was determined at p<0.05. The study enrolled 100 primiparous women, including 10 underweight, 24 normal weight, 28 overweight, and 38 obese participants. Analysis revealed a significant decrease in Hb levels among obese individuals compared to the normal weight group. Moreover, a significant difference in serum ferritin levels was observed between the obese and the other three groups (underweight, normal weight, and overweight). The findings indicated an inverse correlation between high BMI and serum ferritin and Hb levels. The study concluded that anemia is more common in obese pregnant women compared to normal-weight women. Furthermore, it demonstrates varying trends of iron-deficiency anemia (IDA) in relation to the body mass index (BMI) of pregnant women.

Tourniquet Use Improves Intraoperative Parameters, Leading to Similar Postoperative Outcomes Compared With No Tourniquet Use in Anterior Cruciate Ligament Reconstruction: A Prospective, Double-Blind, Randomized Clinical Trial

To examine the effect of tourniquet use in arthroscopic anterior cruciate ligament reconstruction in terms of: (1) intraoperative visualization with operative time and consumption of sterile saline, and (2) intra- and postoperative blood loss, postoperative pain, opioid consumption, swelling, serum creatine phosphokinase (CPK) and hemoglobin (Hb) concentrations, clinical outcomes, and graft healing. In this prospective randomized clinical trial, patients were assigned to tourniquet inflation (tourniquet-up) or tourniquet deflation (tourniquet-down) groups. Primary outcomes were intraoperative visualization with operative time and sterile saline consumption. Secondary outcomes were intra- and postoperative blood loss, postoperative pain, opioid consumption, swelling, serum CPK, Hb concentration, subjective and objective functional scores, and graft healing. Intraoperative visualization was satisfactory in 100 of 100 cases in the tourniquet-up group and 64 of 100 cases in the tourniquet-down group (P < .05). The mean operative time was 58.4 ± 5.7 minutes in the tourniquet-up group and 72.5 ± 8.6 minutes in the tourniquet-down group (P < .05). The mean sterile saline consumption was 6.4 ± 2.5 L in the tourniquet-up group and 8.7 ± 4.6 L in the tourniquet-down group (P < .05). The respective amounts of estimated intraoperative and postoperative blood loss were 95.3 ± 25.1 mL and 240.3 ± 44.5 mL in the tourniquet-up group and 230.2 ± 22.3 mL and 75.6 ± 15.3 mL in the tourniquet-down group (P < .05). Our results showed no significant difference in postoperative pain, opioid consumption, percentage of patients using opioids, swelling, mean serum CPK and Hb levels, subjective and objective functional scores, or graft healing (P > .05) between the 2 groups. Tourniquet use during anterior cruciate ligament reconstruction significantly improves intraoperative visualization, shortens operative time, and decreases intraoperative sterile saline consumption and blood loss without serious adverse events or greater complication rates based on early postoperative outcomes. Level I, randomized controlled trial.

Predictive factors for massive hemorrhage in women with retained products of conception: a prospective study

Retained products of conception (RPOC) is a common cause of postpartum bleeding, which may be life-threatening; however, no evidence-based guidelines exist to assist in evaluating the risk of massive hemorrhage in women with RPOC. In this prospective study, we aimed to evaluate the predictive factors for massive hemorrhage in women with RPOC. The primary and secondary endpoints were to validate the usefulness of power Doppler color scoring (PDCS) in evaluating hypervascularity and to identify other predictive factors (such as maximum RPOC diameter and serum βhCG and Hb level at first visit), respectively. Among the 51 women with RPOC included in this study, 16 (31.5%) experienced massive hemorrhage during follow-up. None of the women with PDCS 1 or 2 (18) experienced massive hemorrhage, whereas 16 (48.5%) women with PDCS 3 or 4 (33) did. Multiple logistic regression analysis showed that the odds ratio [95% confidence interval] (P value) for PDCS, assisted reproductive technology (ART), and low serum hemoglobin (Hb) levels were 22.39 [2.25 − 3087.92] (P = 0.004), 5.72 [1.28 − 33.29] (P = 0.022), and 4.24 [0.97 − 22.99] (P = 0.056), respectively. Further, the decision tree method identified PDCS, ART, and low serum Hb levels as potential predictive factors for massive hemorrhage. This study identified PDCS as useful predictor of massive hemorrhage in women with RPOC. With additional inclusion of factors such as ART and low serum Hb levels, the risk of massive hemorrhage may be effectively evaluated, leading to better management of women of reproductive age.

Establishment of a Nomogram Model for Predicting Cardiovascular and Cerebrovascular Events in Diabetic Nephropathy Patients Receiving Maintenance Hemodialysis

Objective The objective of this study is to explore the risk factors of cardiovascular and cerebrovascular events (CCE) in patients with diabetic nephropathy (DN) receiving maintenance hemodialysis, and to establish a nomogram model on this basis. Method 144 patients with DN receiving maintenance hemodialysis from February 2020 to February 2021 were selected and followed up for 12 months. They were divided into the occurrence and nonoccurrence groups according to whether CCE occurred. The multivariate logistic regression analysis was used to analyze the influencing factors of CCE, and a predictive nomogram model was established. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive effect of the nomogram model. The Hosmer-Lemeshow method was used to test the calibration degree. Results Among the patients, 63 patients (43.75%) encountered CCE. Multivariate logistic regression analysis showed that age >60 years old, history of CCE, dialysis age >12 months, systolic blood pressure >140 mmHg, blood phosphorus level >1.5 mmol/L, triglyceride (TG) level >2.30 mmol/l, adiponectin (ADPN) level <5 mg/L, high-sensitivity-C-reactive protein (hs-CRP) level >10 mg/L, hemoglobin (Hb) level <120 g/L, serum creatinine (SCr) level >720 μmol/L, and albumin (ALB) level <40 g/L were independent risk factors for CCE. Based on the above independent risk factors, a nomogram model of CCE was created. ROC curve analysis showed that the area under curve for predicting CCE was 0.881 (95% CI: 0.833~0.919), indicating that the nomogram model had great predictive effect. The Hosmer-Lemeshow method showed that the calibration curve was in good agreement with the standard curve. Conclusion Age, history of CCE, dialysis age, systolic blood pressure and serum phosphorus, and TG, ADPN, hs-CRP, Hb, SCr, and ALB levels are all influencing factors for the occurrence of CCE in patients with DN receiving maintenance hemodialysis, and the nomogram model has a great predictive effect on CCE.

Weekly Iron Supplementation in 2-Year-Olds is Effective in Combating Anaemia

Introduction: Iron deficiency anaemia is a serious public health problem in developing countries, especially among children, as it is associated with serious developmental problems.&#x0D; Objective: To assess the effects of weekly ferrous sulphate supplementation on haemoglobin (Hb) levels and the prevalence of anaemia in children aged 2 to 3 years.&#x0D; Methods: A cluster-randomized clinical trial was conducted; two schools were randomly chosen. In the first school, the children received 6mg/kg of elemental iron in the form of iron sulphate once a week (intervention). In the other school, the children received a placebo (control). The intervention group had 44 participants at the end of the study, and the control group had 48 children. Blood samples were taken at baseline and at the end of the study to assess serum Hb levels and anaemia prevalence. The intervention lasted 14 weeks.&#x0D; Results: There was a mean increase in Hb of 0.85g/dL (p=0.0003) in the intervention group and a decrease of 0.74g/dL (p=0.0001) in the control group. The prevalence of anaemia significantly decreased in the weekly supplementation group with p=0.0002.&#x0D; Conclusion: Weekly iron supplementation in preschool-age children promoted a significant increase in Hb levels and a decrease in the prevalence of anaemia.

Predictive value of serum adiponectin and hemoglobin levels for vascular cognitive impairment in ischemic stroke patients.

Objectives:To investigate the potential predictive value of serum adiponectin (APN) and hemoglobin (Hb) levels for the occurrence of vascular cognitive impairment in ischemic stroke patients.Methods:Eighty ischemic stroke patients, admitted to our hospital between June 2019 and November 2020, were retrospectively divided into no cognitive impairment (NCI) group (n=43) and cognitive impairment (CI) group (n=37) based on Montreal Cognitive Assessment (MoCA) scale scoring at three months follow-up. ELISA was used to assess serum Hb and APN levels and receiver operating characteristic (ROC) curves were created to evaluate correlation.Results:Serum APN and Hb levels were lower in the vascular cognitive impairment group compared to non-impaired counterparts. Pearson correlation analysis showed that both APN and Hb levels were positively correlated with MoCA scores. Area under curve analysis indicated predictive value for serum APN and Hb for predicting cognitive impairment in ischemic stroke patients.Conclusion:Serum APN and Hb levels in ischemic stroke patients have value for predicting vascular cognitive impairment and may be suitable for helping dictate treatment planning.

Role of Hepcidin as a biomarker for iron status in patients on regular hemodialysis after treatment of hepatitis C virus

Abstract Background Hepcidin, an acute phase reactant protein produced in the liver, is a key regulator of iron homeostasis. Because of its renal elimination and regulation by inflammation, it is possible that progressive renal insufficiency leads to altered hepcidin metabolism. Aim of the work to assess effect of HCV treatment on hepcidin levels in regular heamodialysis patients and its relation to iron status. Patients and Methods This cross sectional study was conducted on 45 ESRD patients on regular hemodialysis. All candidates included in this study subjected to careful history taking, full clinical examination and investigations (including complete blood count, HCVAb, HBVsAg and HIVAb). All patients had positive antibodies for hepatitis C; however, all of them had negative PCR and negative HIV, HBV antibodies. Results In our study, dry weight ranged from 46 to 117 kg with mean 77.36. Weight gain ranged from 2 to 5 kg with mean 3.09.About 87% of patients had LTAVF access. About 12 patients (27%) received blood transfusion once. Timing of transfusion ranged from 4 to 60 month with median of 24 months. Regarding frequency of epoetin dose, 11 patients (24.4%) did not receive epoetin, 16 patients (35.6%) received it twice/week. Only 3 patients (6.7%) received iron therapy for time ranging from 3 to 5 months with mean of 4 months. Mean Hb concentration in our study population was 10.11 ±1.64 gm/dl. The mean of iron was 64.22 ±19.52, TIBC was 409.96 ± 67.85, ferritin was 394.56 ± 239.22 and TSAT% was 22.6 ±7.36. The mean serum hepcidin was 218.51 ±127. Our study demonstrated that increase in serum hepcidin is associated with lower serum Hb and iron levels. On the other hand, there is statistically significant positive correlation between serum hepcidin and both serum ferritin and transferrin saturation. Conclusion Median hepcidin value is elevated in dialysis ESRD patients due to increased inflammation and decreased clearance of hepcidin. Also serum hepcidin levels were lowered in HCV patients. Therefore ESRD patients on maintenance HD after treatment of HCV infection showed elevated levels of serum hepcidin.

Telomere shortening in patients on long-term hemodialysis

BackgroundLeukocyte telomere length shortening is a characteristic of premature senescence, a process that can be accelerated by oxidative stress. In general, patients with end-stage renal disease undergoing regular hemodialysis (HD) are repeatedly exposed to oxidative stress. Patients undergoing HD tend to have cardiovascular diseases associated with oxidative stress and inflammation. Therefore, we assumed that telomere length is associated with HD vintage and the degree of vascular calcification. MethodsA total of 144 patients undergoing regular HD before kidney transplantation and 62 patients on hemodialysis, but not undergoing kidney transplantation, were enrolled. We measured common laboratory values, such as calcium, phosphate, and hemoglobin levels, and assessed the degree of vascular calcification in the patients. The leukocyte telomere length was measured using reverse transcription polymerase chain reaction, and Spearman correlation was used for correlation analysis. ResultsThe leukocyte telomere length was negatively associated with age (rho = −0.306, P＜0.01); it was shorter in middle-aged patients than in young patients (13.48 ± 4.80 vs. 15.86 ± 4.51, P < 0.01). The telomere length was significantly different among patients aged 52–74 years in groups with different HD vintages. Additionally, the telomere length was positively associated with serum hemoglobin (Hb) levels in all patients (rho = 0.290, P < 0.01). There was a significant difference among patients divided into three groups according to the degree of anemia (17.09 ± 5.64 vs. 14.40 ± 4.07 vs. 13.99 ± 3.95, P < 0.01). Further, a significant difference was observed in the telomere length among patients with different degrees of vascular calcification (16.79 ± 4.91 vs. 13.61 ± 2.82 vs. 14.62 ± 3.63 vs. 10.71 ± 3.74, P < 0.01). The telomere length was shorter in the patients on hemodialysis who did not receive a kidney transplant than in the surgical patients (8.12 ± 1.83 vs. 14.33 ± 4.63, P < 0.01). ConclusionThis study demonstrated that the telomere length was significantly correlated with HD vintage in patients of a certain age group. The telomere length was shorter in patients on hemodialysis who matched for age and dialysis vintage with kidney transplant patients. It was also associated with vascular calcification and serum Hb levels in all patients undergoing HD.

Effects of heavy metal, vitamin, and curry consumption on metabolic syndrome during menopause: a Korean community-based cross-sectional study.

To determine the associations between metabolic syndrome (MetS) during menopause and serum heavy metal levels and vitamin and curry consumption. A data set of 7,131 pre- and postmenopausal women aged ≥ 20 years collected between 2009 and 2017 was used to obtain information on sociodemographic, lifestyles, family histories, food intakes, and serum heavy metal levels and MetS. Logistic regression was used to identify associations between the presence of MetS and risk factors and to predict risks of MetS based on marginal effects. Our results show that postmenopausal women had a higher risk of MetS than premenopausal women. During postmenopause elevations in the levels of serum cadmium by one unit increased the risk of MetS by 33% (OR 1.33; 95% CI, 1.03-1.72, P = 0.028). Risks of MetS in pre- and postmenopausal women, when serum Hb levels increased by 1 unit increased 21% (OR 1.21; 95% CI, 1.09-1.33, P < 0.001) and 26% (OR 1.26; 95% CI, 1.16-1.38, P < 0.001), respectively. Furthermore, the risk of MetS risk in pre- and postmenopausal women was increased 2.49-fold and 2.79-fold by a 1% increase in HbA1c level (OR 2.49; 95% CI, 1.97-3.16, P < 0.001) and (OR 2.79; 95% CI, 2.30-3.38, P < 0.001), respectively. High curry consumption reduced the risk of MetS significantly more than low curry consumption (OR 0.60; 95% CI, 0.39-0.91, P = 0.017) in premenopausal women. Furthermore, an increase in daily vitamin B2 intake by 1 mg reduced the risk of MetS by 45% (OR 0.55; 95% CI, 0.32-0.94, P = 0.028) in postmenopausal women. Vitamin B2 and curry supplementation may protect against MetS. Further work is needed to reduce risk factors associated with heavy metals and determine the effects of vitamins and curry consumption on MetS during menopause.

Relationship between serum iron level and febrile convulsion in children

The aim of the present study was to evaluate the relationship between febrile convulsion, serum iron levels and whole blood parameters. This cross-sectional case-control study included patients aged 6 months-6 years-old brought to the department of pediatrics of Kütahya ParkHayat Hospital with febrile convulsions between January 2015 and December 2019. The patients were divided into two groups as: febrile with convulsions (study group; n= 47) and febrile without convulsions (control group; n= 35). Both groups were age and sex-matched. Some blood parameters such as mean serum iron, ferritin, Hb and MCV levels were used to compare the groups. Mean serum iron levels of the study and control groups were 33.7 ± 2.1 μg/dL and 56.3 ± 7.4 μg/dL (p&lt;0.05), and serum ferritin levels were 27.3 ± 6.2 ng/mL and 31.1 ± 2.1 ng/ mL (p&gt;0.05), respectively. Mean hemoglobin levels of the study and control groups were 10.6 ± 1.7 g/dL and 11.1 ± 1.4 g/dL (p &lt;0.05), and mean MCV levels were 71.1 ± 1.2 fL and 73.2 ± 1.1 fL (p&gt;0.05), respectively. In the light of the findings of this study, the low serum iron and ferritin levels may be reinforcing factors for developing febrile convulsion. However, multicentre studies with more patients are needed to reach a precise conclusion.

Roxadustat for the treatment of anemia in patients with chronic kidney diseases: a meta-analysis.

Background: Anemia is a common complication of chronic kidney disease (CKD). Treating renal anemia with erythropoiesis-stimulating agents (ESAs) or erythropoietin analogs is effective but has side effects. Therefore, we performed a meta-analysis to assess the efficacy and safety of roxadustat in treating CKD-induced anemia.Methods: We searched publications online and conducted a meta-analysis and calculated relative risks with 95% confidence intervals (CIs) for dichotomous data and mean differences (MD) with 95% CIs for continuous data.Results: Of 110 articles, nine were included that contained 12 data sets and 11 randomized control trials on roxadustat. In the non-dialysis-dependent (NDD) high-dose/low-dose subgroups, the change in hemoglobin (Hb) levels was significantly higher in the roxadustat group than in the placebo group (P<0.0001, P=0.001, respectively). The Hb response rate of the roxadustat is higher in the NDD subgroup than in the placebo group (P<0.00001, MD=6.92, 95% CI: 4.03, 11.89). However, in the dialysis-dependent subgroup, there was no significant difference in the change in Hb levels or the Hb response rate between the roxadustat and ESA groups. There was no change in the mortality in the roxadustat group compared to that in the placebo/ESA group. Hyperkalemia may be a side effect of roxadustat.Conclusions: Roxadustat elevated the serum Hb levels in a manner similar to that observed for ESAs. Roxadustat raised the Hb levels more significantly than the placebo and showed a higher Hb response rate than the placebo group in NDD patients. Roxadustat is a safe and effective drug for anemia in CKD patients.

Serum hemoglobin concentration and risk of renal function decline in early stages of diabetic kidney disease: a nationwide, biopsy-based cohort study.

Prognosticating disease progression in patients with diabetic kidney disease (DKD) is challenging, especially in the early stages of kidney disease. Anemia can occur in the early stages of kidney disease in diabetes. We therefore postulated that serum hemoglobin (Hb) concentration, as a reflection of incipient renal tubulointerstitial impairment, can be used as a marker to predict DKD progression. Drawing on nationally representative data of patients with biopsy-proven DKD, 246 patients who had an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 at renal biopsy were identified: age 56 (45-63) years; 62.6% men; Hb 13.3 (12.0-14.5) g/dL; eGFR 76.2 (66.6-88.6) mL/min/1.73 m2; urine albumin-to-creatinine ratio 534 (100-1480) mg/g Crea. Serum Hb concentration was divided into quartiles: ≤12, 12.1-13.3, 13.4-14.5 and ≥14.6 g/dL. The association between serum Hb concentration and the severity of renal pathological lesions was explored. A multivariable Cox regression model was used to estimate the risk of DKD progression (new onset of end-stage kidney disease, 50% reduction of eGFR or doubling of serum creatinine). The incremental prognostic value of DKD progression by adding serum Hb concentration to the known risk factors of DKD was assessed. Serum Hb levels negatively correlated with all renal pathological features, especially with the severity of interstitial fibrosis (ρ = -0.52; P < 0.001). During a median follow-up of 4.1 years, 95 developed DKD progression. Adjusting for known risk factors of DKD progression, the hazard ratio in the first, second and third quartile (the fourth quartile was reference) were 2.74 [95% confidence interval (CI) 1.26-5.97], 2.33 (95% CI 1.07-5.75) and 1.46 (95% CI 0.71-3.64), respectively. Addition of the serum Hb concentration to the known risk factors of DKD progression improved the prognostic value of DKD progression (the global Chi-statistics increased from 55.1 to 60.8; P < 0.001). Serum Hb concentration, which reflects incipient renal fibrosis, can be useful for predicting DKD progression in the early stages of kidney disease.