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Renal functional and structural integrity in infants with iron deficiency anemia: relation to oxidative stress and
Mohamed S El-Shimi1, Rania A El-Farrash, Eman A Ismail
1Pediatrics Department, Faculty of Medicine, Ain Shams University, Abbassya Square, Cairo, Egypt.
Insights
Iron deficiency anemia (IDA) in infants adversely affects kidney function and structure. Iron therapy reversed these changes, indicating oxidative stress plays a key role in IDA-related renal injury.
Area of Science:
- Pediatric Nephrology
- Nutritional Anemias
- Oxidative Stress Research
Background:
- Iron deficiency anemia (IDA) is a global nutritional deficiency.
- Infants with IDA exhibit impaired renal functional and structural integrity.
- Oxidative stress is implicated in the pathogenesis of renal injury in IDA.
Purpose of the Study:
- To evaluate and compare renal integrity in infants with IDA versus healthy controls.
- To assess the relationship between IDA, oxidative stress, and response to iron therapy.
Main Methods:
- Prospective study of 50 infants with IDA and 50 controls.
- Analysis of serum iron profile, urinary markers (microalbumin, LAP), FeNa, TAC, MDA, and trace elements.
- 3-month follow-up with oral iron therapy.
Main Results:
- IDA patients showed higher urinary microalbumin and LAP, lower TAC, zinc, and magnesium, and higher MDA and copper.
- MDA correlated positively with microalbumin and LAP.
- Iron therapy decreased urinary markers and increased hemoglobin and ferritin.
Conclusions:
- IDA negatively impacts renal function and structure in infants.
- Renal impairment associated with IDA is reversible with iron therapy.
- Oxidative stress is a significant factor in IDA-induced renal injury.
Background:
Iron deficiency anemia (IDA) is the most common nutritional deficiency in the world. The aim of our study was to evaluate and compare renal functional and structural integrity in 50 infants with IDA and 50 healthy controls and to assess the relation between IDA and oxidative stress and response to iron therapy.
Methods:
This was a prospective study in which peripheral blood samples were collected from all study subjects and the following laboratory investigations performed: serum iron profile, urinary microalbumin, urinary leucine aminopeptidase (LAP), fractional excretion of sodium (FeNa), serum total antioxidant capacity (TAC), serum malondialdehyde (MDA), serum and urinary trace elements (iron, copper, zinc, calcium and magnesium). All patients received oral iron therapy and were followed-up for 3 months.
Results:
The levels of baseline urinary markers were higher among the patients with IDA than among the controls (p < 0.05). Patients had a lower pre-therapy TAC and lower serum zinc and magnesium levels than controls as well as higher MDA and serum copper levels (p < 0.05). MDA level was positively correlated to microalbumin and LAP level (p < 0.05). Urinary LAP concentration was positively correlated to urinary trace element concentrations (p < 0.05). A significant decrease in microalbumin, LAP, FeNa, and urinary trace elements was observed post-iron therapy while hemoglobin and ferritin levels were increased (p < 0.05).
Conclusion:
Among the study subjects, IDA had an adverse influence on renal functional and structural integrity which could be reversed with iron therapy. Oxidative stress played an important role in the pathogenesis of renal injury in IDA.
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