title: The Growth Attainment, Hematological, Iron Status and Inflammatory Profile of Guatemalan Juvenile End-Stage Renal Disease Patients.
abstract: BACKGROUND
  Stunting, anemia and inflammation are frequently observed in children with end-stage renal disease (ESRD).
  
  
  OBJECTIVE
  To assess anthropometric, hematological and inflammatory data and to study their potential interrelationship in Guatemalan juveniles undergoing hemodialysis (HD) and peritoneal dialysis (PD).
  
  
  METHODS
  54 juveniles 7-20 years of age were recruited in FUNDANIER, Guatemala City: 27 on HD and 27 PD. Hemoglobin, serum iron, transferrin, serum transferrin receptor (sTfR), serum ferritin, transferrin saturation and iron-binding capacity, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), as well as IL-6, IL-1 and TNF-α, weight and height were determined by standard methods. Hepcidin-25 (Hep-25) was assessed by weak cation exchange time-of-flight mass-spectrometry.
  
  
  RESULTS
  92% and 55% of HD and PD children, respectively, were stunted and 95% and 85% were anemic. Among iron status biomarkers, serum ferritin was massively increased and significantly higher in the HD group compared to the PD group. Hep-25 was also greatly elevated in both groups. 41% of HD patients showed increments in three or more inflammatory biomarkers, while it was 2 or less in all PD subjects.
  
  
  CONCLUSIONS
  The degree of stunting, the prevalence and severity of anemia in Guatemalan juvenile ESRD far exceed the national statistics for this low-income Central American country. Ferritin and Hep-25 concentrations were elevated, with the latter to an extraordinary magnitude. Additional biomarkers of inflammation not directly related to iron status were elevated as well. The role of both disease- and environment-related factors in combination best explains the magnitude of the biomarker abnormalities.
authors.affiliation: Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala; MBR Optical Systems, Wuppertal, Germany.
authors.forename: Juliana
authors.initials: J
authors.lastname: Casimiro de Almeida
authors.affiliation: Fundación para el Niño Enfermo Renal (FUNDANIER), Roosevelt Hospital, Guatemala City, Guatemala.
authors.forename: Randall
authors.initials: R
authors.lastname: Lou-Meda
authors.affiliation: MBR Optical Systems, Wuppertal, Germany.
authors.forename: Marion
authors.initials: M
authors.lastname: Olbert
authors.affiliation: Department of Internal Medicine VI, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Seifert
authors.affiliation: Department of Internal Medicine VI, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Günter
authors.initials: G
authors.lastname: Weiss
authors.affiliation: Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Hepcidinanalysis.com at the Department of Laboratory Medicine of the Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
authors.forename: Erwin T
authors.initials: ET
authors.lastname: Wiegerinck
authors.affiliation: Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Hepcidinanalysis.com at the Department of Laboratory Medicine of the Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
authors.forename: Dorine W
authors.initials: DW
authors.lastname: Swinkels
authors.affiliation: Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala.
authors.forename: Noel W
authors.initials: NW
authors.lastname: Solomons
authors.affiliation: Molecular Nutrition Unit, ZIEL, Research Center for Nutrition and Food Science, Technische Universität München, Freising, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Schümann
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D001837:Body Weights and Measures; D002648:Child; D005260:Female; D005293:Ferritins / Q000097:blood; D006166:Guatemala / Q000453:epidemiology; D064451:Hepcidins / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D007501:Iron / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D008297:Male; D055815:Young Adult
chemical_list: D064451:Hepcidins; C545475:hepcidin 25, human; D005293:Ferritins; D007501:Iron