Effectiveness of Lactoferrin in the Treatment of Anemia in Chronic Kidney Disease: A Single-Center Pilot Study

Author:

Kekan Kushal1,Divyaveer Smita1,Kashyap Madhuri1,Premkumar Madhumita2,Zohmangaihi Deepy3,Mallik Nabhajit4,Lad Deepesh5,Sharma Akanksha1,Gowri Shankar S1,Garg Sahil1,Prabhahar Arun1,Chaudhary Ankur1,Suleiman Shabna1,Rather Imran6,Verma Manish3,Jassal Ravjit Singh3,Kohli Harbir Singh1

Affiliation:

1. Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

2. Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

3. Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India

4. Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

5. Department of Clinical Hematology and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

6. Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Abstract

Abstract Background: Anemia occurs in majority of patients with chronic kidney disease despite adequate dialysis and iron replete status. This study was done to evaluate the effects of lactoferrin with or without iron supplementation for the treatment of anemia in patients with chronic kidney disease (CKD). Methods: In this prospective, observational, single-center, single-arm pilot study, adult patients aged >18 years, having stage 5 CKD (estimated glomerular filtration rate [eGFR] <15 ml/min/1.73 m2), and who had anemia (hemoglobin [Hb] <10 g/dl; transferrin saturation [Tsat] >20%) were included. Patients were treated with 100 mg of oral lactoferrin twice a day for one month with or without iron supplementation. Patients had been on stable erythropoietin doses for ≥1 month prior to inclusion in the study. We report on the improvement in Hb levels and effect on inflammatory markers from baseline at four weeks. Results: A total of 46 CKD patients having anemia were included. Patients had a mean age of 39.3 years, and a majority were men (69.6%). Improvement in the mean (SD) Hb level (g/dl) was observed from baseline (8.18 [1.19]) to Week 2 (8.54 [1.57]), which attained significance at Week 4 (8.96 [1.93]; P < 0.001; mean difference: −0.76; 95% confidence interval [CI]: −1.291 to − 0.2383). The improvement in Hb was higher in women than in men (P = 0.48) and in patients receiving lactoferrin with iron supplementation than in those receiving lactoferrin alone (P = 0.14). There was a non-significant decrease in the erythrocyte sedimentation rate (P = 0.14) and a non-significant increase in C-reactive protein (P = 0.54) level. Conclusions: Oral lactoferrin therapy was effective in improving hemoglobin levels in patients with advanced CKD and anemia. The effects of lactoferrin therapy on inflammatory markers remain uncertain.

Publisher

Medknow

Subject

Nephrology

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