title: Iron homeostasis in relapsing steroid-sensitive nephrotic syndrome of childhood.
abstract: OBJECTIVE
  Urinary transferrin loss is a typical feature in relapse of the idiopathic nephrotic syndrome, however, the impact on serum iron homeostasis and hematological parameters has not been studied systematically so far.
  
  
  METHODS
  Therefore, we investigated serum iron (Fe), erythropoietin (EPO), ferritin (FN), transferrin (TF), total iron-binding capacity (TEBK), transferrin saturation and the soluble transferrin receptor (sTFR) combined with hematological parameters (hemoglobin, MCV, MCH) in 42 children with relapsing, steroid-sensitive nephrotic syndrome (NS) in remission (RM, n = 26) and relapse (RL, n = 16), including 13 patients who were studied in both states. Thirty-three age-matched healthy children served as controls.
  
  
  RESULTS
  Fe, TEBK and TF were significantly reduced in RL compared to RM in cross-sectional as well as in paired studies while ferritin, hematological parameters and EPO levels remained unchanged. A significant increase, however, of the soluble transferrin-receptor could be demonstrated in cross-sectional analysis comparing RL to RM and healthy controls (3568+/-713 mg/ml vs 2625+/-576 vs 2646+/-697; p < 0.001 respectively) as well as in paired analysis of 13 patients in RL and RM (p < 0.001).
  
  
  CONCLUSIONS
  We conclude that transient transferrin and iron deficiency occurs in RL of INS but this seems to be counterbalanced by upregulation of the sTFR, a mechanism that might be important in preventing the development of iron deficiency anemia during the active nephrotic state.
authors.affiliation: Sektion Pädiatrische Nephrologie, Universitäts-Kinderklinik Eppendorf, Hamburg, Germany.
authors.forename: M J
authors.initials: MJ
authors.lastname: Kemper
authors.forename: A B
authors.initials: AB
authors.lastname: Bello
authors.forename: H
authors.initials: H
authors.lastname: Altrogge
authors.forename: K
authors.initials: K
authors.lastname: Timmermann
authors.forename: K
authors.initials: K
authors.lastname: Ludwig
authors.forename: D E
authors.initials: DE
authors.lastname: Müller-Wiefel
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004921:Erythropoietin / Q000097:blood; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins; D006706:Homeostasis; D006801:Humans; D007501:Iron / Q000097:blood* / Q000378:metabolism; D009404:Nephrotic Syndrome / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology; D012008:Recurrence; D012016:Reference Values; D014168:Transferrin / Q000378:metabolism
chemical_list: D006454:Hemoglobins; D014168:Transferrin; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron