Study Of The Iron Metabolism And EPO Levels In Nephrotic Syndrome Children

Objective:to measure the level of urinary transferrin(TF), serum iron(SI),serum ferritin(SF),serum transferrin receptor (sTfR)and erythropoietin(EPO)in children with Nephrotic Syndrome so as to study the relation of microcytic hypochromic anemia and iron metabolism and study the level of EPO.Methods:Peripheral blood and urinary specimens were obtained from 50 cases of the children with Nephrotic Syndrome and 30 cases of normal Controls.concentrations of TF,SF,sTfR and EPO were examined by Enzyme Linked Immunosorbent Assays(ELISA). Concentrations of SI were examined by Graphite Furnace Atomic Absorption Spectrometry(GFAAS).Results:①the level of TF in NS patients with anemia(5.73±2.84 mg/L)and in NS patients with non-anemia(4.91±2.83 mg/L)was significantly higher than the mean value in the control group(0.95±0.24 mg/L,P＜0.01);TF levels were no difference between NS patients with anemia and with non-anemia(P＞0.05),②the level of SI in NS patients with anemia(1.03±0.33 ug/mL)and in NS patients with non-anemia(1.38±0.48 ug/mL)was significantly lower than the mean value in the control group(1.95±0.61 ug/mL,P＜0.01);the level of SI in NS patients with anemia was lower than that in NS patients with non-anemia(P＜0.05).③there were no difference in SF levels among NS patients with anemia,NS patients with non-anemia and the control group.④the level of sTfR in NS patients with anemia(18.02±6.39nmol/L)and in NS patients with non-anemia(14.64±4.86nmol/L) was significantly higher than the mean value in the control group(11.14±4.21 nmol/L,P<0.05);the level of sTfR in NS patients with anemia was higher than that in NS patients with non-anemia(P <0.05).⑤EPO levels in NS patients with anemia(6.41±3.73mIU/mL) were significantly lower than that in the control group(10.84±3.73 mIU/mL)and in NS patients with non-anemia(9.85±4.92 mIU/mL); there were no significantly difference between the control group and NS patients with non-anemia.⑥in NS patients with anemia,there were no difference in TF,SI,sTfR and EPO levels between simple NS patients and nephritis NS patients(P>0.05).⑦sTfR positively correlated to urinary TF(P<0.01)in NS patients;SI negatively correlated to urinary TF(P<0.01)in NS patients;SF did not correlate to urinary TF in NS patients(P>0.05);EPO did not correlate to sTfR in NS patients(P>0.05).Conclusion:①NS patients had loss of urinary TF.②there was correlation between the increase of sTfR,the decrease of SI and the loss of urinary TF in NS patients.③the level of sTfR in NS patients with anemia was higher than that in NS patients with non-anemia;the level of SI in NS patients with anemia was lower than that in NS patients with non-anemia;The microcytic hypochromic anemia in NS patients was related to the abnormity of iron metabolism which was caused by the loss of urinary TF.④sTfR was a more sensitive parameter than SF to evaluate iron metabolism in NS patients.⑤the decrease of EPO levels might be the reason of the anemia in NS patients.⑥the turbulence of iron metabolism and the change of EPO levels were not related to the type of primary NS.