Iron In Kidney Disease
ironjustice
Fanconi Syndrome and CKD in a Patient With Paroxysmal
Nocturnal Hemoglobinuria and Hemosiderosis.
Am J Kidney Dis. 2009 Oct 13.
Hsiao PJ, Wang SC, Wen MC, Diang LK, Lin SH.
Division of Nephrology, Department of Medicine,
Tri-Service General Hospital,
National Defense Medical Center, Taipei.
Fanconi syndrome and chronic kidney disease associated with
paroxysmal nocturnal hemoglobinuria is rarely reported.
We describe a 51-year-old woman with glomerular filtration rate
decrease and hypokalemia, glucosuria, and proteinuria during a
4-year period.
Paroxysmal nocturnal hemoglobinuria was diagnosed 17 years
earlier, and she has received multiple blood transfusions because
of hemolytic episodes during the last 5 years.
Deteriorating kidney function and persistent Fanconi syndrome
were accompanied by a progressive increase in serum ferritin levels.
Laboratory studies showed proximal renal tubular acidosis,
hypophosphotemic hyperphosphaturia, normoglycemic glucosuria,
and aminoaciduria.
Serologic testing, tumor markers, Bence-Jones protein, and heavy-
metal
screening results were negative.
Abdominal magnetic resonance imaging showed characteristic features
of iron deposition in the bilateral renal cortices.
Kidney biopsy showed chronic interstitial nephritis with prominent
hemosiderin deposition in the proximal tubules.
With potassium citrate, calcitriol, and deferoxamine therapy, Fanconi
syndrome persisted, but kidney function was stable.
Renal hemosiderosis secondary to both chronic repetitive hemolytic
episodes and transfusion-related iron overload in patients with
paroxysmal nocturnal hemoglobinuria can lead to Fanconi syndrome
and chronic kidney disease.
PMID: 19833423
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transfusions, as in this person.
What has this to do with kidney disease otherwise?
ironjustice
"Hemosiderosis and iron overload can lead to chronic kidney disease"
<<
Effect of tocotrienols on iron-induced renal dysfunction and oxidative
stress in rats
Amitt Gupta a; Kanwaljit Chopra a
Drug and Chemical Toxicology, Volume 32, Issue 4 October 2009 , pages
319 - 325
a Pharmacology Division, University Institute of Pharmaceutical
Sciences,
Panjab University, Chandigarh, India
Abstract
Ferric nitrilotriacetate (Fe-NTA) is a well-established nephrotoxic
agent.
This study was designed to investigate the modulatory effect of the
subacute
administration of tocotrienol-rich fraction (T3), a product from palm
oil, and
-tocopherol (T) on Fe-NTA-induced renal injury and oxidative stress.
Fe-NTA administration markedly increased blood urea nitrogen (BUN)
and
serum creatinine level, which was coupled with a marked lipid
peroxidation,
reduced activity of glutathione levels, and morphological alterations
in rat
kidney.
Pretreatment with T3 (50 mg/kg/day) and T (50 mg/kg/day) for 7 days
before
Fe-NTA administration significantly reduced the serum creatinine and
BUN
levels, reduced lipid peroxidation in a significant manner, and
restored levels
of reduced glutathione and superoxide dismutase.
T3 pretreatment also attenuated the serum tumor necrosis factor-alpha
levels,
as compared to pretreatment with T, and restored normal renal
morphology.
These findings suggest a strong correlation between iron-induced
oxidative
stress and renal dysfunction and point toward the protective effects
of T3
in Fe-NTA-induced renal injury.
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>
> Fanconi Syndrome and CKD in a Patient With Paroxysmal
> Nocturnal Hemoglobinuria and Hemosiderosis.
> Am JKidneyDis. 2009 Oct 13.
> Hsiao PJ, Wang SC, Wen MC, Diang LK, Lin SH.
>
> Division of Nephrology, Department of Medicine,
> Tri-Service General Hospital,
> National Defense Medical Center, Taipei.
>
> Fanconi syndrome and chronickidneydisease associated with
> paroxysmal nocturnal hemoglobinuria is rarely reported.
> We describe a 51-year-old woman with glomerular filtration rate
> decrease and hypokalemia, glucosuria, and proteinuria during a
> 4-year period.
> Paroxysmal nocturnal hemoglobinuria was diagnosed 17 years
> earlier, and she has received multiple blood transfusions because
> of hemolytic episodes during the last 5 years.
> Deterioratingkidneyfunction and persistent Fanconi syndrome
> were accompanied by a progressive increase in serum ferritin levels.
> Laboratory studies showed proximal renal tubular acidosis,
> hypophosphotemic hyperphosphaturia, normoglycemic glucosuria,
> and aminoaciduria.
> Serologic testing, tumor markers, Bence-Jones protein, and heavy-
> metal
> screening results were negative.
> Abdominal magnetic resonance imaging showed characteristic features
> ofirondeposition in the bilateral renal cortices.Kidneybiopsy showed chronic interstitial nephritis with prominent
> hemosiderin deposition in the proximal tubules.
> With potassium citrate, calcitriol, and deferoxamine therapy, Fanconi
> syndrome persisted, butkidneyfunction was stable.
> Renal hemosiderosis secondary to both chronic repetitive hemolytic
> episodes and transfusion-relatedironoverload in patients with