Renal functional and structural integrity in infants with iron deficiency anemia: relation to oxidative stress and response to iron therapy

• Published in: Pediatric nephrology (Berlin, West) Vol. 30; no. 10; pp. 1835 - 1842
• Main Authors: El-Shimi, Mohamed S., El-Farrash, Rania A., Ismail, Eman A., El-Safty, A., Nada, Ahmed S., El-Gamel, Omayma A., Salem, Yomna M., Shoukry, Sara M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2015; Springer; Springer Nature B.V
• Subjects: Administration, Oral; Anemia; Anemia, Iron-Deficiency - drug therapy; Anemia, Iron-Deficiency - metabolism; Anemia, Iron-Deficiency - physiopathology; Antioxidants; Biomarkers - blood; Biomarkers - urine; Child, Preschool; Complications and side effects; Copper; Demographic aspects; Enzymes; Female; Females; Follow-Up Studies; Glomerular Filtration Rate - physiology; Humans; Infant; Iron; Iron - blood; Iron Compounds - administration & dosage; Iron Compounds - therapeutic use; Iron deficiency anemia; Kidney - physiopathology; Kidney diseases; Male; Males; Medicine; Medicine & Public Health; Metabolism; Nephrology; Original Article; Oxidative Stress; Pathogenesis; Pediatrics; Polyethylene; Prospective Studies; Reactive Oxygen Species - metabolism; Renal Insufficiency - etiology; Renal Insufficiency - physiopathology; Renal Insufficiency - prevention & control; Risk factors; RNA polymerase; Time Factors; Trace elements; Treatment Outcome; Urology; Egypt; Cairo Egypt; Japan; Oxidative stress; Trace elements; Renal impairment; Iron therapy; Iron deficiency anemia; Glomerular damage
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s00467-015-3122-6

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.