European Journal of Molecular & Clinical Medicine

Background: The present study aimed to evaluate the levels of serum iron, total iron
binding capacity (TIBC), transferrin saturation and serum ferritin in diagnosed cases of
chronic kidney disease due to any aetiology not undergoing dialysis. Study also aimed to
determine the correlation between serum creatinine and serum iron levels in chronic
kidney disease in this group of patients.
Materials and Methods: The present study was conducted in the city of Dibrugarh and
which also included patients belonging to adjoining districts of Upper Assam from 20th
October 2018 to 19th October 2019 for a period of 1 year. A clinico-hematological study
was undertaken to evaluate the levels of serum iron, total iron binding capacity (TIBC),
transferrin saturation and serum ferritin in diagnosed cases of chronic kidney disease
(not on dialysis) due to any aetiology. Study included 110 old and newly diagnosed cases
of CKD attending the out–patient department not on dialysis. A cut-off off Hemoglobin
<13 g/dl in men and <12 g/dl in women was used to make the diagnosis of anemia.
Results: Prevalence of anemia among CKD cases was observed as 74.6% with Hb level
<6 gm% was observed in 6.4% cases. Normocytic normochromic picture was observed
in 53.6% cases. Decreased level of serum iron, ferritin, TIBC and transferrin saturation
was seen in 99.1%, 16.4%, 52.75 and 78.2% cases respectively. Mean levels of
haemoglobin, RBC and iron indices (except for TIBC levels) decreased significantly
with increase in the CKD stage. A significant positive correlation was observed between
eGFR levels with haemoglobin and iron indices (except TIBC) while an inverse
correlation was observed with creatinine levels.
Conclusion: Anemia among Pre dialysis-CKD cases is mostly normocytic and moderate
in severity. Functional iron deficiency was the predominant form of iron deficiency in
these patients. Both hemoglobin and other iron indices worsens with progressive loss of
kidney functions.

One of the most common causes of dialysis is diabetic nephropathy (DN), which can be
prevented or delayed with early identification. When it comes to chronic kidney disease (CKD)
and type 2 diabetes, little is known about the renal function marker serum cystatin C (sCysC) and
its link to glomerular filtration rate. In this study, we tested the efficacy of sCysC as a marker of
early DN and CKD in patients from the southern Indian coastal region

Purpose. To identify prognostic factors for the development of renal dysfunction (RD) and to develop a method for
assessing and predicting RD in patients with chronic heart failure (CHF).
Methods. A total of 101 patients with functional class I-III (FC) CHF (according to the classification of the New
York Heart Association) were examined. Also, the patients were divided, depending on the glomerular filtration
rate, determined by the calculation method according to the CKD-EPI formula (eGFR), into two groups: patients
with eGFR≥90 ml / min (n = 20), with eGFR <90 ml / min (n = 81). All patients were determined: creatinine (Cr),
eGFR according to the CKD-EPI formula, albumin / creatinine (Al / Cr) level (mg / mmol) in morning urine,
specific gravity in morning urine portion (SG); studied renal blood flow according to Doppler sonography at the
level of the common left and right renal arteries. To assess the significance of signs for determining and predicting
RD in CHF, we used a method based on Wald's sequential statistical analysis with the development of differential
diagnostic tables, determination of diagnostic coefficients (DC) and information content (J) of each sign in groups of
patients with CHF, depending on the level eGFR, determination of diagnostic thresholds (amount of DC).
Results. As a result of the developed differential diagnostic tables, the most informative signs were identified that
determine the unfavorable prognosis of RD in patients with CHF: creatinine above 80 μmol / l, eGFR less than 90
ml / min, Al / Cr ratio in morning urine more than 3.4 mg / mmol, urine specific gravity SG less than 1015,
resistance index (RI) at the level of the right and left renal arteries more than 0.7. The sum of DCs of these signs,
depending on the severity of symptoms, determines the risk of developing RD: a very high risk in the range from
+15 to +32, high risk - from +8 to +14, moderate risk - from +7 to +3, favorable course of CHF - from 0 to +2
points.
Conclusion. Signs of an unfavorable prognosis for the development of RD in patients with CHF were determined:
creatinine above 80 μmol / l, eGFR less than 90 ml / min, Al / Cr ratio in morning urine more than 3.4 mg / mmol, urine SG less than 1015, RI at the renal level arteries more than 0.7.

Background: Anemia is a common complication in Chronic kidney disease (CKD) patients. It has a multi-factorial pathogenesis. Replenishing iron stores and giving ESAs are the main lines of treatment. There is a general agreement on the optimal route for iron supplementation in ESRD patients with the IV route but there is no such agreement on the optimal route for iron supplementation in pre-dialysis CKD patients. Erythropoiesis stimulating agents (ESAs) treatment represent an economic burden and has been linked to possible cardiovascular side effects. This study amid to assessing the efficacy of erythropoietin in treatment of anemia in CKD patients. Methods: A prospective cohort study was conducted in chronic kidney disease patients who had undergone hemodialysis in Met-Ghamr hospital of nephrology from February 2019 to July 2019. Included 50 patients on maintenance hemodialysis, we tested the efficacy through comparing the efficacy low fixed ESA dose (4000 IU IV once weekly) versus high fixed dose (4000 IU IV three times weekly). We divided group into two groups, group A and group B. group A were put on a fixed dose of 4000 IU Epoetin alfa once weekly and group B were put on a fixed dose of 4000 IU Epoetin alfa three times weekly. Results: After 6 months, We found a significant difference in hemoglobin response of the two subgroups in favor of subgroup IID (P = 0.004). Conclusion: That low dose ESAs is less effective in correction of anemia in dialysis patients than high dose ESAs.

The aim of the study was to review the features of the functional state of the kidneys in patients with cardiopathy, betting on the presentation of the components of the metabolic syndrome. For the research we examined 197 male patients with chronic heart condition (CHF) of ischemic genesis of II-III functional class (FC) in line with NYHA. Metabolic syndrome in patients with chronic heart failure HFmrEF exacerbates impaired renal function, which has developed together of the most pathogenetic links in chronic heart condition. it's been established that because the metabolic syndrome progresses (attachment of T2DM to other components of the metabolic syndrome), the phenomena of functional kidney failure increase. Evidence of the importance of the metabolic syndrome within the nature of the clinical manifestations of chronic coronary failure HFmrEF is that the established dependence of the identified disorders on the severity of the metabolic syndrome.