Effect of Lactoferrin on Hemoglobin, Erythroferrone, and Hepcidin Levels in Chronic Kidney Disease Patients With Anemia: A Post-hoc Analysis

Anemia affects nearly 60% of patients with stage 4-5 chronic kidney disease (CKD) in India. [1][2]2][3] Functional iron deficiency, driven by elevated hepcidin and inflammationassociated suppression of erythropoiesis, is a major contributor to anemia.Hepcidin regulates systemic iron by degrading ferroportin, whereas erythroferrone, produced by erythroblasts, counteracts hepcidin to promote iron availability during active erythropoiesis. 4hronic inflammation and reduced renal clearance increase hepcidin levels, limiting intestinal iron absorption and iron release from stores. 5Our team published a pilot study to evaluate the effectiveness of lactoferrin, an ironbinding glycoprotein with anti-inflammatory properties, in improving anemia in patients with CKD. 6 We found a modest benefit of add-on lactoferrin.This post hoc analysis in the stored samples evaluates whether this small beneficial effect of lactoferrin is associated with any changes in the iron metabolism parameters, hepcidin, and erythroferrone.