الفهرس 
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Abstract
Anemia is one of the main problems in hemodialysis patients, which is caused by inadequate production of erythropoietin. Functional iron deficiency (FID) anemia is a kind of anemia, which lack of functional iron therein leads to resistance and inappropriate response to erythropoietin in hemodialysis patients.
Lactoferrin is a multifunctional protein of the transferrin family. Lactoferrin is a globular glycoprotein with a molecular mass of about 80 kDa that is widely represented in various secretory fluids, such as milk, saliva, tears, and nasal secretions. Lactoferrin is also present in secondary granules of PMN and is secreted by some acinar cells. Lactoferrin can be purified from milk or produced recombinantly. Human colostrum (”first milk”) has the highest concentration, followed by human milk, then cow milk (150 mg/L).
LF is considered one of the components of the immune system of the body; it has bactericide and fungicide antimicrobial activity. LF interacts with DNA and RNA, polysaccharides and heparin, and shows some of its biological functions in complexes with these ligands. It acts as a mediator linking innate and adaptive immune responses.
LF promotes iron absorption as it has 300 times higher affinity to iron as compared with serum transferrin. It maintains the balance of iron within the normal range and helps to avoid both ID and iron overload. Due to these reasons, LF is added to many commercial products of infant formulae.
LF from bovine milk is the main LF used in human medicine because of its easy availability and has been designated by the United States Food and Drug Administration as a food additive that is generally recognized as safe.
Many studies have been done to evaluate the effect of oral LF administration on IDA with controversial results. A few among the numerous protective activities exercised by this protein, after its oral administration, are antianemic, anti-inflammatory, antimicrobial, immunomodulatory, anti-oxidant, and anticancer activities. These multiple significances in host defense and health- promoting functions of LF and its wide real-life applications have stimulated increased research interest, which may play a role in solving global health problems such as IDA.
The aim of the present study was to study the effect and safety of oral lactoferrin therapy for functional iron deficiency anemia in prevalent hemodialysis patients.
This was Randomized clinical trial, was conducted at El Demerdash hemodialysis unit on 70 prevalent hemodialysis patients divided into 2 groups: (group A): included 35 patients with functional iron deficiency anemia, received lactoferrin together with the recommended dose of ESA therapy for 3 months, (group B): included 35 patients with functional iron deficiency anemia, received no lactoferrin apart from the recommended dose of ESA therapy for 3 months.
The main results of the study revealed that:
There was no statistically significant difference between the two studied groups (group A and group B) as regard sex, occupation, residence and age.
There was no statistically significant difference between the two studied groups (group A and group B) as regard height, weight and BMI.
There was no statistically significant difference between the two studied groups (group A and group B) as regard history.
There was no statistically significant difference between the two studied groups (group A and group B) as regard hemoglobin and WBCs.
There was no statistically significant difference between the two studied groups (group A and group B) as regard PLT and Reticulocyte %.
There was no statistically significant difference between the two studied groups (group A and group B) as regard ferritin, serum iron and TSAT.
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.