title: Renal functional and structural integrity in infants with iron deficiency anemia: relation to oxidative stress and response to iron therapy.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Pediatrics Department, Faculty of Medicine, Ain Shams University, Abbassya Square, Cairo, Egypt.
authors.forename: Mohamed S
authors.initials: MS
authors.lastname: El-Shimi
authors.forename: Rania A
authors.initials: RA
authors.lastname: El-Farrash
authors.forename: Eman A
authors.initials: EA
authors.lastname: Ismail
authors.forename: Ibrahim A
authors.initials: IA
authors.lastname: El-Safty
authors.forename: A
authors.initials: A
authors.lastname: El-Safty
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Nada
authors.forename: Omayma A
authors.initials: OA
authors.lastname: El-Gamel
authors.forename: Yomna M
authors.initials: YM
authors.lastname: Salem
authors.forename: Sara M
authors.initials: SM
authors.lastname: Shoukry
mesh_terms: D000284:Administration, Oral; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007223:Infant; D007501:Iron / Q000097:blood*; D058085:Iron Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D018384:Oxidative Stress; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000378:metabolism; D051437:Renal Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D058085:Iron Compounds; D017382:Reactive Oxygen Species; D007501:Iron