{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:06:54Z","timestamp":1791662814800,"version":"4.3.4"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>\n                    Hepcidin is secreted in inflammatory states as in patients on regular hemodialysis (HD). Therefore, novel agents modulating hepcidin secretion may have the potential to effectively reverse anemia in HD patients. Bovine milk derivative lactoferrin (BLF) is a glycoprotein that was found to decrease serum interleukin-6, therefore, having anti-inflammatory properties. Thus, it can downregulate hepcidin secretion in various inflammatory states including patients on regular HD, so improving iron absorption and utilization in those patients. In addition, BLF is a source of iron as each BLF molecule chelates two ferric ions. We started an interventional study. Seventy patients on regular HD with iron deficiency anemia received 100 mg of 20%\u201330% iron-saturated BLF (corresponding to 70\u201384 \u03bcg of elemental iron) orally b.i.d for 6 months. We compared those patients with another 70 patients on regular HD with iron deficiency anemia who were given 576 mg of ferrous glycine sulfate (corresponding to 100 mg of elemental iron) orally b.i.d for 6 months. BLF significantly decreased serum hepcidin level (from 340\u2013350 ng\/mL to 101\u2013112 ng\/mL),\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt;0.0001 and significantly increased hemoglobin (Hb) concentration (from 7.5\u20138.1 g\/dL to 9.3\u201310 g\/dL),\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt;0.0001, and transferrin saturation (TSAT) (from 5%\u20139% to 26%\u201331%),\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt;0.0001. Furthermore, ferrous glycine sulfate significantly decreased serum hepcidin level (from 335-350 ng\/mL to 330-\u2013341 ng\/mL),\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt;0.0001, and significantly increased Hb (from 7.5\u20138.1 to 7.6\u20138.5 g\/dL),\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt;0.0001, and TSAT (from 5%\u20139% to 7%\u201312%),\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt;0.0001. However, the magnitude of decrease in serum hepcidin level and rise in Hb and TSAT in the BLF group was significantly higher than in the ferrous glycine sulfate group,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt;0.0001. Oral BLF can be considered a promising novel agent in treatment of iron deficiency anemia in patients on regular HD.\n                  <\/jats:p>","DOI":"10.4103\/1319-2442.393996","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T11:05:32Z","timestamp":1705316732000},"page":"235-241","source":"Crossref","is-referenced-by-count":10,"title":["Lactoferrin: A Promising New Player in Treatment of Iron Deficiency Anemia in Patients on Regular Hemodialysis: A Randomized Controlled Trial"],"prefix":"10.4103","volume":"34","author":[{"given":"Rabab Mahmoud Ahmed","family":"Mahmoud","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AbdelAal","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"R1-20240117","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1111\/j.1744-9987.2010.00836.x","article-title":"2008 Japanese society for dialysis therapy: Guidelines for renal anemia in chronic kidney disease","volume":"14","author":"Tsubakihara","year":"2010","journal-title":"Ther Apher Dial"},{"key":"R2-20240117","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1093\/ndt\/gfr431","article-title":"Serum hepcidin-25 levels and anemia in non-dialysis chronic kidney disease patients: A cross-sectional study","volume":"27","author":"Uehata","year":"2012","journal-title":"Nephrol Dial Transplant"},{"key":"R3-20240117","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1038\/ki.2010.254","article-title":"Intra-individual variability in serum hepcidin precludes its use as a marker of iron status in hemodialysis patients","volume":"78","author":"Ford","year":"2010","journal-title":"Kidney Int"},{"key":"R4-20240117","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.2215\/CJN.05931108","article-title":"Hepcidin -A potential novel biomarker for iron status in chronic kidney disease","volume":"4","author":"Zaritsky","year":"2009","journal-title":"Clin J Am Soc Nephrol"},{"key":"R5-20240117","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.3390\/ijms18091985","article-title":"Lactoferrin: A natural glycoprotein involved in iron and inflammatory homeostasis","volume":"18","author":"Rosa","year":"2017","journal-title":"Int J Mol Sci"},{"key":"R6-20240117","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/s10534-014-9742-7","article-title":"Lactoferrin prevents LPS-induced decrease of the iron exporter ferroportin in human monocytes\/macrophages","volume":"27","author":"Cutone","year":"2014","journal-title":"Biometals"},{"key":"R7-20240117","doi-asserted-by":"crossref","first-page":"705","DOI":"10.3389\/fimmu.2017.00705","article-title":"Lactoferrin efficiently counteracts the inflammation-induced changes of the iron homeostasis system in macrophages","volume":"8","author":"Cutone","year":"2017","journal-title":"Front Immunol"},{"key":"R8-20240117","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1503\/cmaj.071131","article-title":"Anemia of chronic disease: A harmful disorder or an adaptive, beneficial response?","volume":"179","author":"Zarychanski","year":"2008","journal-title":"CMAJ"},{"key":"R9-20240117","doi-asserted-by":"crossref","first-page":"498","DOI":"10.3390\/nu10040498","article-title":"Serum hepcidin concentration in individuals with sickle cell anemia: Basis for the dietary recommendation of iron","volume":"10","author":"Omena","year":"2018","journal-title":"Nutrients"},{"key":"R10-20240117","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1093\/ndt\/gfp546","article-title":"Serum hepcidin-25 levels in patients with chronic kidney disease are independent of glomerular filtration rate","volume":"25","author":"Peters","year":"2010","journal-title":"Nephrol Dial Transplant"},{"key":"R11-20240117","doi-asserted-by":"crossref","first-page":"125","DOI":"10.4103\/0971-4065.70840","article-title":"Iron status, inflammation and hepcidin in ESRD patients: The confounding role of intravenous iron therapy","volume":"20","author":"Jairam","year":"2010","journal-title":"Indian J Nephrol"},{"key":"R12-20240117","doi-asserted-by":"crossref","first-page":"2450","DOI":"10.1093\/ndt\/gfn267","article-title":"Hepcidin: A new tool in the management of anaemia in patients with chronic kidney disease?","volume":"23","author":"Swinkels","year":"2008","journal-title":"Nephrol Dial Transplant"},{"key":"R13-20240117","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1177\/147323001103900542","article-title":"Serum hepcidin in haemodialysis patients: Associations with iron status and microinflammation","volume":"39","author":"Xu","year":"2011","journal-title":"J Int Med Res"},{"key":"R14-20240117","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1002\/eji.200939889","article-title":"Differential regulation of iron homeostasis during human macrophage polarized activation","volume":"40","author":"Recalcati","year":"2010","journal-title":"Eur J Immunol"},{"key":"R15-20240117","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.3324\/haematol.2010.023879","article-title":"Polarization dictates iron handling by inflammatory and alternatively activated macrophages","volume":"95","author":"Corna","year":"2010","journal-title":"Haematologica"},{"key":"R16-20240117","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1179\/2047773212Y.0000000043","article-title":"Body iron delocalization: The serious drawback in iron disorders in both developing and developed countries","volume":"106","author":"Paesano","year":"2012","journal-title":"Pathog Glob Health"},{"key":"R17-20240117","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1023\/B:BIOM.0000027710.13543.3f","article-title":"Cellular internalization of lactoferrin in intestinal epithelial cells","volume":"17","author":"Ashida","year":"2004","journal-title":"Biometals"},{"key":"R18-20240117","doi-asserted-by":"crossref","first-page":"10915","DOI":"10.1021\/bi8012164","article-title":"The N1 domain of human lactoferrin is required for internalization by caco-2 cells and targeting to the nucleus","volume":"47","author":"Suzuki","year":"2008","journal-title":"Biochemistry"},{"key":"R19-20240117","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1007\/s10534-014-9723-x","article-title":"Safety and efficacy of lactoferrin versus ferrous sulphate in curing iron deficiency and iron deficiency anaemia in hereditary thrombophilia pregnant women: An interventional study","volume":"27","author":"Paesano","year":"2014","journal-title":"Biometals"},{"key":"R20-20240117","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1139\/o06-040","article-title":"Oral administration of lactoferrin increases hemoglobin and total serum iron in pregnant women","volume":"84","author":"Paesano","year":"2006","journal-title":"Biochem Cell Biol"},{"key":"R21-20240117","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.biochi.2008.06.004","article-title":"The influence of lactoferrin, orally administered, on systemic iron homeostasis in pregnant women suffering of iron deficiency and iron deficiency anaemia","volume":"91","author":"Paesano","year":"2009","journal-title":"Biochimie"},{"key":"R22-20240117","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1177\/039463201002300220","article-title":"Lactoferrin efficacy versus ferrous sulfate in curing iron disorders in pregnant and non-pregnant women","volume":"23","author":"Paesano","year":"2010","journal-title":"Int J Immunopathol Pharmacol"},{"key":"R23-20240117","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s10534-018-0087-5","article-title":"The ferroportin-ceruloplasmin system and the mammalian iron homeostasis machine: Regulatory pathways and the role of lactoferrin","volume":"31","author":"Bonaccorsi","year":"2018","journal-title":"Biometals"},{"key":"R24-20240117","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1080\/0886022X.2018.1532909","article-title":"Hemoglobin targets for the anemia in patients with dialysis-dependent chronic kidney disease: A meta-analysis of randomized, controlled trials","volume":"40","author":"Ye","year":"2018","journal-title":"Ren Fail"}],"container-title":["Saudi Journal of Kidney Diseases and Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/1319-2442.393996","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:02:05Z","timestamp":1787763725000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/1319-2442.393996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":24,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/1319-2442.393996","relation":{},"ISSN":["1319-2442","2320-3838"],"issn-type":[{"value":"1319-2442","type":"print"},{"value":"2320-3838","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023]]}}}