Effect of Lactoferrin Administration on Serum Iron Status of Children on Regular Hemodialysis

Background: This study aimed to evaluate the effect of lactoferrin administration on serum iron status of children on regular hemodialysis.

Methods: This case-controlled study was carried on 60 children with end stage renal disease on regular hemodialysis and 30 healthy children served as a control group. Patients were classified into 2 groups, group A: 30 patients received oral lactoferrin supplementation 100 mg for 3 months and group B: 30 patients received oral lactoferrin supplementation plus oral iron 5mg/kg/day for 3 months. Serum ferritin, transferrin saturation (TSAT), serum hepcidin and IL6 were measured before and after supplementation

Results: Serum ferritin was significantly higher in patient groups compared to controls before the supplementation (P <0.001) but significantly decreased after supplementation (P= <0.001). No significance difference between patient groups in serum ferritin levels before or after the supplementation (P=0.778, P=0.763) respectively. TSAT was significantly lower in patients groups compared to controls before the supplementation (p<0.001) but showed significant decrease after supplementation in group A (P=0.036) and significant increase in group B after the supplementation (P<0.001). TSAT was significantly increased in group B compared to group A (P<0.001). Serum hepcidin and serum interleukin 6 levels were higher in patients than controls before supplementation but significantly decreased at the end of the study in patient groups. . There were positive correlations between serum hepcidin and interleukin 6, CRP, and ferritin levels but a negative correlation with hemoglobin and TSAT. There was a positive correlation between serum IL-6 and both CRP and ferritin but a negative correlation between IL-6 and both Hb and TSAT.

Conclusions: Oral lactoferrin was not able to maintain iron status in HD children while Lactoferrin plus oral iron was effective in treating iron deficiency in HD patients.