Evidence map›Paper›PMID 26268514›Full record

Trial reportBMC nephrology2015

Effects of carnitine on oxidative stress response to intravenous iron administration to patients with CKD: impact of haptoglobin phenotype.

Zaher Armaly, Amir Abd El Qader, Adel Jabbour, Kamal Hassan, Rawi Ramadan, Abdalla Bowirrat, Bishara Bisharat

Open access · goldAbstract readClinical Trial
In one paragraph

Trial report in BMC nephrology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Zaher ArmalyDepartment of Nephrology, Nazareth Hospital-EMMS, Nazareth, 16100, Israel. ZaherArmaly@NAZHOSP.com.
Amir Abd El QaderDepartment of Nephrology, Nazareth Hospital-EMMS, Nazareth, 16100, Israel. amirabed@gmail.com.
Adel JabbourDepartment of Laboratory Medicine, Nazareth Hospital-EMMS, Nazareth, Israel. adeljabour@nazhosp.com.
Kamal HassanDepartment of Nephrology, Western Galilee Hospital, Nahariya, Israel. drkamalh@hotmail.com.
Rawi RamadanDepartment of Nephrology, Rambam Health Campus, Haifa, Israel. r_ramadan@rambam.health.gov.il.
Abdalla BowirratDepartment of Nephrology, Nazareth Hospital-EMMS, Nazareth, 16100, Israel. bowirrat@gmail.com.
Bishara BisharatDepartment of Nephrology, Nazareth Hospital-EMMS, Nazareth, 16100, Israel. Bishara@nazhosp.com.
Nazareth Hospital EMMS · ILBar-Ilan University · ILRambam Health Care Campus · ILWestern Galilee Hospital · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnemia is a common disorder in CKD patients. It is largely attributed to decreased erythropoietin (EPO) production and iron deficiency. Therefore, besides EPO, therapy includes iron replenishment. However, the latter induces oxidative stress. Haptoglobin (Hp) protein is the main line of defense against the oxidative effects of Hemoglobin/Iron. There are 3 genotypes: 1-1, 2-1 and 2-2. Hp 2-2 protein is inferior to Hp 1-1 as antioxidant. So far, there is no evidence whether haptoglobin phenotype affects iron-induced oxidative stress in CKD patients. Therefore, the present study examines the influence of carnitine treatment on the intravenous iron administration (IVIR)-induced oxidative stress in CKD patients, and whether Hp phenotype affects this response.

methods

trial registrationCurrent Controlled Trials ISRCTN5700858. This study included 26 anemic (Hb = 10.23 ± 0.28) CKD patients (stages 3-4) that were given a weekly IVIR (Sodium ferric gluconate, [125 mg/100 ml] for 8 weeks, and during weeks 5-8 also received Carnitine (20 mg/kg, IV) prior to IVIR. Weekly blood samples were drawn before and after each IVIR for Hp phenotype, C-reactive protein (CRP), advanced oxidative protein products (AOPP), neutrophil gelatinase-associated lipocalin (NGAL), besides complete blood count and biochemical analyses.

resultsEight percent of CKD patients were Hp1-1, 19 % Hp2-1, and 73 % Hp2-2. IVIR for 4 weeks did not increase hemoglobin levels, yet worsened the oxidative burden as was evident by elevated plasma levels of AOPP. The highest increase in AOPP was observed in Hp2-2 patients. Simultaneous administration of Carnitine with IVIR abolished the IVIR-induced oxidative stress as evident by preventing the elevations in AOPP and NGAL, preferentially in patients with Hp2-2 phenotype.

conclusionsThis study demonstrates that Hp2-2 is a significant risk factor for IVIR-induced oxidative stress in CKD patients. Our finding, that co-administration of Carnitine with IVIR preferentially attenuates the adverse consequences of IVIR, suggests a role for Carnitine therapy in these patients.

Indexed as

Acute-Phase ProteinsAdvanced Oxidation Protein ProductsAgedAnemia, Iron-DeficiencyCarnitineC-Reactive ProteinCross-Over StudiesFemaleFerric CompoundsGenotypeHaptoglobinsHumansLipocalin-2LipocalinsMaleMiddle AgedAcute-Phase ProteinsAdvanced Oxidation Protein ProductsCarnitineC-Reactive ProteinFerric Compoundsferric gluconateHaptoglobinsLCN2 protein, humanLipocalin-2LipocalinsProto-Oncogene Proteins

Identifiers

PMID26268514
PMCPMC4535251
OpenAlexW2131765975

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.