NGAL and Hepcidin Levels in Hemodialysis Patients in Assiut University Hospital

Study Overview
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Brief Summary
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To assess the pattern of NGAL and Hepicidin in relation to anemia in End Stage Renal Disease Patients on regular hemodialysis in Assiut University Hospital and study the relation between both NGAL and Hepicidin.

Detailed Description
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Patients with chronic kidney disease have a chronic inflammatory state, due to many factors e.g. enhancedincidence of infections, the uremic milieu, elevated levels of proinflammatory cytokines, frequent presence of widespread arteriosclerosis, etc. Iron metabolism is disturbedin chronic inflammatory diseases.AlteredNGAL levels in hemodialysis patients was probablydue to the fact that this protein was involved in ironmetabolism and suggested that NGAL might be anew tool in the assessment of iron deficiency.Another study found in multipleregression analysis that; residual renal function, hepcidin,creatinine and hsCRP were predictors of serum NGAL inhemodialyzed patients. They concluded that NGAL is highly induced in dialyzed patients and could reflect both kidney function and iron metabolism.Several studies suggested that hepcidin plays a role as anegative regulator of intestinal iron absorption and ironrelease from macrophages. Hepcidin controls intestinal ironabsorption by regulating ferroportin expression on thebasolateral membrane of enterocytes .Hepicidin is also an acute phase reactant.Both NGAL and hepcidin are elevated inchronic kidney disease,not only through ironmetabolism, but both are also associated with inflammationand may be related to anemia. Possible relationship between NGAL and hepicidin is still under study.

Official Title
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Assessment of Neutrophil Gelatinase Associated Lipocalin (NGAL) and Hepcidin Levels in Hemodialysis Patients in Assiut University Hospital

Conditions
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CKD (Chronic Kidney Disease) Stage 5D

Intervention / Treatment
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* Diagnostic Test: NGAL and Hepcidin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: For group 1: Adults > 18 years. Age and sex matched. No active infection or inflammation. For group 2: Adults > 18 years. ESRD patients on regular hemodialysis. Hgb < 11g/dl. No apparent infection or inflammation. For group 3: Adults > 18 years. ESRD patients on regular hemodialysis. Hgb ≥ 11g/dl. No apparent infection or inflammation. Exclusion Criteria: Children and those >60 Years. Pregnant female. Patients with severe infection or with other immune system diseases.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Control healthy subjects without anemia.<br>Adults > 18 years. Age and sex matched. No active infection or inflammation. | Diagnostic Test: NGAL and Hepcidin<br>* Both NGAL and hepcidin are elevated inchronic kidney disease,not only through iron metabolism, but both are also associated with inflammationand may be related to anemia<br>|
| ESRD with Hgb <11 g/dl.<br>Adults > 18 years. ESRD patients on regular hemodialysis. Hgb < 11g/dl. No apparent infection or inflammation. | Diagnostic Test: NGAL and Hepcidin<br>* Both NGAL and hepcidin are elevated inchronic kidney disease,not only through iron metabolism, but both are also associated with inflammationand may be related to anemia<br>|
| ESRD with Hgb ≥ 11 g/dl<br>Adults > 18 years. ESRD patients on regular hemodialysis. Hgb ≥ 11g/dl. No apparent infection or inflammation. | Diagnostic Test: NGAL and Hepcidin<br>* Both NGAL and hepcidin are elevated inchronic kidney disease,not only through iron metabolism, but both are also associated with inflammationand may be related to anemia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of Neutrophil Gelatinase Associated Lipocalin (NGAL) and Hepcidin levels in Hemodialysis patients in Assiut University Hospital, 60 patients and 12 controls will be recruited. | Assess the pattern of NGAL and Hepicidin in relation to anemia in End Stage Renal Disease Patients on regular hemodialysis in Assiut University Hospital and study the relation between both NGAL and Hepicidin. | Bseline |