Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and β-globin mRNA expression

Abstract Background Sudanese children with End-Stage Kidney Disease (ESKD) often show limited improvement in hemoglobin levels despite treatment with recombinant human erythropoietin (rHuEPO). This study aims to assess the response to rHuEPO therapy by analyzing β-globin mRNA expression and reticulo...

Full description

Saved in:
Bibliographic Details
Main Authors: Abier Abdelaziz Makkawi Abdelrahman, Ahmed Ibrahim Marzouk, Osama Ali Altayeb, Eman Abbas Fadul, Mugtaba Osman, Nahla Allam, Nadia Madani Mohammed Ahmed, Nazik Elmalaika Obaid Seid Ahmed Husain
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Nephrology
Subjects:
Online Access:https://doi.org/10.1186/s12882-024-03806-5
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850203887931228160
author Abier Abdelaziz Makkawi Abdelrahman
Ahmed Ibrahim Marzouk
Osama Ali Altayeb
Eman Abbas Fadul
Mugtaba Osman
Nahla Allam
Nadia Madani Mohammed Ahmed
Nazik Elmalaika Obaid Seid Ahmed Husain
author_facet Abier Abdelaziz Makkawi Abdelrahman
Ahmed Ibrahim Marzouk
Osama Ali Altayeb
Eman Abbas Fadul
Mugtaba Osman
Nahla Allam
Nadia Madani Mohammed Ahmed
Nazik Elmalaika Obaid Seid Ahmed Husain
author_sort Abier Abdelaziz Makkawi Abdelrahman
collection DOAJ
description Abstract Background Sudanese children with End-Stage Kidney Disease (ESKD) often show limited improvement in hemoglobin levels despite treatment with recombinant human erythropoietin (rHuEPO). This study aims to assess the response to rHuEPO therapy by analyzing β-globin mRNA expression and reticulocyte parameters. Additionally, it classifies anemia among Sudanese pediatric patients based on iron status, considering age and gender as biological markers for evaluating treatment response. Methods A prospective observational cohort study was conducted from January 2019 to February 2020 in Khartoum, Sudan, involving 45 anemic children aged 2 to 15 years diagnosed with ESKD. The treatment protocol included rHuEPO injections and maintenance hemodialysis. Laboratory assessments consisted of complete blood count (CBC), absolute reticulocyte count, ferritin, and transferrin measurements. β-globin mRNA expression was quantified using reverse transcription polymerase chain reaction (RT-PCR), and reticulocyte parameters, including Reticulocyte Hemoglobin Content (CHr), percentage of hypochromic reticulocytes (HYPO%), and Immature Reticulocyte Fraction (IRF), were measured via flow cytometry. Results Significant variations in hemoglobin levels were observed across different age groups (p = 0.011). Gender analysis revealed a significant association with IRF, showing a lower IRF in male patients (p = 0.017). However, there were no significant differences in hemoglobin levels between genders (p = 0.999). β-globin mRNA expression showed considerable variability, with a strong positive correlation with hemoglobin levels (r = 0.875, p < 0.0001). Conclusion Age and gender significantly influence treatment responses in children with ESKD, highlighting the need to consider growth physiology in anemia management. This study underscores the variability in β-globin mRNA expression and its association with Flow Cytometry parameters, demonstrating their effectiveness in evaluating iron status and guiding rHuEPO dosage.
format Article
id doaj-art-1c29c328305e40ffac127357e2bb0059
institution OA Journals
issn 1471-2369
language English
publishDate 2024-10-01
publisher BMC
record_format Article
series BMC Nephrology
spelling doaj-art-1c29c328305e40ffac127357e2bb00592025-08-20T02:11:24ZengBMCBMC Nephrology1471-23692024-10-0125111210.1186/s12882-024-03806-5Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and β-globin mRNA expressionAbier Abdelaziz Makkawi Abdelrahman0Ahmed Ibrahim Marzouk1Osama Ali Altayeb2Eman Abbas Fadul3Mugtaba Osman4Nahla Allam5Nadia Madani Mohammed Ahmed6Nazik Elmalaika Obaid Seid Ahmed Husain7Department of Haematology, College of Graduate Studies and Scientific Research, Karary UniversityDelta Scientific Consultation Center AlexendriaFlowcytometry LaboratoryFlowcytometry LaboratoryUmm Salal Treatment and Rehabilitation Centre, Department of Psychiatry, Hamad Medical CorporationDepartment of Pediatrics, Faculty of Medicine, Al Neelain UniversityDepartment of Haematology, Faculty of Medical Laboratories, Karrary UniversityDepartment of Pathology, Faculty of Medicine and Health Sciences, Omdurman Islamic UniversityAbstract Background Sudanese children with End-Stage Kidney Disease (ESKD) often show limited improvement in hemoglobin levels despite treatment with recombinant human erythropoietin (rHuEPO). This study aims to assess the response to rHuEPO therapy by analyzing β-globin mRNA expression and reticulocyte parameters. Additionally, it classifies anemia among Sudanese pediatric patients based on iron status, considering age and gender as biological markers for evaluating treatment response. Methods A prospective observational cohort study was conducted from January 2019 to February 2020 in Khartoum, Sudan, involving 45 anemic children aged 2 to 15 years diagnosed with ESKD. The treatment protocol included rHuEPO injections and maintenance hemodialysis. Laboratory assessments consisted of complete blood count (CBC), absolute reticulocyte count, ferritin, and transferrin measurements. β-globin mRNA expression was quantified using reverse transcription polymerase chain reaction (RT-PCR), and reticulocyte parameters, including Reticulocyte Hemoglobin Content (CHr), percentage of hypochromic reticulocytes (HYPO%), and Immature Reticulocyte Fraction (IRF), were measured via flow cytometry. Results Significant variations in hemoglobin levels were observed across different age groups (p = 0.011). Gender analysis revealed a significant association with IRF, showing a lower IRF in male patients (p = 0.017). However, there were no significant differences in hemoglobin levels between genders (p = 0.999). β-globin mRNA expression showed considerable variability, with a strong positive correlation with hemoglobin levels (r = 0.875, p < 0.0001). Conclusion Age and gender significantly influence treatment responses in children with ESKD, highlighting the need to consider growth physiology in anemia management. This study underscores the variability in β-globin mRNA expression and its association with Flow Cytometry parameters, demonstrating their effectiveness in evaluating iron status and guiding rHuEPO dosage.https://doi.org/10.1186/s12882-024-03806-5β-globin mRNA expressionEnd-stage kidney disease (ESKD)FerritinFlow cytometryHypochromic cells (HYPO%)Immature reticulocyte fraction (IRF)
spellingShingle Abier Abdelaziz Makkawi Abdelrahman
Ahmed Ibrahim Marzouk
Osama Ali Altayeb
Eman Abbas Fadul
Mugtaba Osman
Nahla Allam
Nadia Madani Mohammed Ahmed
Nazik Elmalaika Obaid Seid Ahmed Husain
Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and β-globin mRNA expression
BMC Nephrology
β-globin mRNA expression
End-stage kidney disease (ESKD)
Ferritin
Flow cytometry
Hypochromic cells (HYPO%)
Immature reticulocyte fraction (IRF)
title Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and β-globin mRNA expression
title_full Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and β-globin mRNA expression
title_fullStr Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and β-globin mRNA expression
title_full_unstemmed Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and β-globin mRNA expression
title_short Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and β-globin mRNA expression
title_sort assessment of myeloid response and iron status among sudanese pediatric eskd on hemodialysis through reticulocyte parameters and β globin mrna expression
topic β-globin mRNA expression
End-stage kidney disease (ESKD)
Ferritin
Flow cytometry
Hypochromic cells (HYPO%)
Immature reticulocyte fraction (IRF)
url https://doi.org/10.1186/s12882-024-03806-5
work_keys_str_mv AT abierabdelazizmakkawiabdelrahman assessmentofmyeloidresponseandironstatusamongsudanesepediatriceskdonhemodialysisthroughreticulocyteparametersandbglobinmrnaexpression
AT ahmedibrahimmarzouk assessmentofmyeloidresponseandironstatusamongsudanesepediatriceskdonhemodialysisthroughreticulocyteparametersandbglobinmrnaexpression
AT osamaalialtayeb assessmentofmyeloidresponseandironstatusamongsudanesepediatriceskdonhemodialysisthroughreticulocyteparametersandbglobinmrnaexpression
AT emanabbasfadul assessmentofmyeloidresponseandironstatusamongsudanesepediatriceskdonhemodialysisthroughreticulocyteparametersandbglobinmrnaexpression
AT mugtabaosman assessmentofmyeloidresponseandironstatusamongsudanesepediatriceskdonhemodialysisthroughreticulocyteparametersandbglobinmrnaexpression
AT nahlaallam assessmentofmyeloidresponseandironstatusamongsudanesepediatriceskdonhemodialysisthroughreticulocyteparametersandbglobinmrnaexpression
AT nadiamadanimohammedahmed assessmentofmyeloidresponseandironstatusamongsudanesepediatriceskdonhemodialysisthroughreticulocyteparametersandbglobinmrnaexpression
AT nazikelmalaikaobaidseidahmedhusain assessmentofmyeloidresponseandironstatusamongsudanesepediatriceskdonhemodialysisthroughreticulocyteparametersandbglobinmrnaexpression