Kidney Week

Abstract: TH-PO878

Exploring the Interplay of Inflammation, Eryptosis, and Anemia in ESKD

Session Information

• Anemia and Iron Metabolism
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Anemia and Iron Metabolism

• 200 Anemia and Iron Metabolism

Authors

• Moreno-Amaral, Andrea Novais, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Andrea Novais Moreno-Amaral, PhD

• Dias, Erika S., Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Erika S. Dias

• Monte-Alegre, Júlia Bacarin, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Júlia Bacarin Monte-Alegre

• Van Spitzenbergen, Beatriz Akemi Kondo, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Beatriz Akemi Kondo Van Spitzenbergen, MS, MSc

• Andrade, Gabriela Bohnen, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Gabriela Bohnen Andrade

• Brugnolo-Santos, Vitor André, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Vitor André Brugnolo-Santos

• Ozogovski, Yuri Daitschman, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Yuri Daitschman Ozogovski

• Ferreira Dias, Gabriela, Renal Research Institute, New York, New York, United States

Gabriela Ferreira Dias, MS, PhD

• Grobe, Nadja, Renal Research Institute, New York, New York, United States

Nadja Grobe, PhD

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko, MD, FASN

• Moraes, Thyago Proença de, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Thyago Proença de Moraes, MD, PhD

Background

Most ESKD patients have some degree of chronic inflammation, which heightens infection risk, elevates pro-inflammatory cytokines, and augments uremic solute accumulation. These events could exacerbate anemia by premature death (eryptosis) of red blood cells (RBC). This study aimed to explore the link between eryptosis, cytokines, and hemoglobin levels (HB) in ESKD dialytic patients.

Methods

Serum from 41 ESKD dialytic patients was analyzed using ELISA for IL-6, IFN-g, TNF-a, and IL-1b. RBC from peripheral blood were annexin-V labeled to assess phosphatidylserine (PS) expression. A nonparametric Spearman test was used to analyze the correlation between the variables, while simple linear regression was employed to quantify the slope and intercept of these relationships.

Results

Figure 1 – As expected, Hb levels correlated inversely with the cytokines INF-g (A, p<0.01) and IL-1b (B, p<0.03) but not with IL-6 (C, p<0.07) and TNF-a (D, p<0.06). Higher PS expression was correlated with lower Hb levels (E, p<0.001). Additionally, significant inverse correlations were observed between PS expression and IFN-g (F, p<0.001), IL-1b (G, p<0.001), and IL-6 (H, p<0.001). However, no significant correlation was found between PS exposure and TNF-a (I, p<0.55).

Conclusion

The results showed a link between low Hb levels and high cytokine concentrations, connecting inflammation with anemia. A significant inverse correlation was also seen between high PS expression and low Hb levels and between PS expression and the cytokines INF-g, IL-1b, and IL-6. These findings imply an association between eryptosis, renal anemia, and inflammation in these patients. This underscores the importance of addressing inflammation and eryptosis to manage anemia, potentially reshaping clinical approaches.