The effect of gum Arabic oral treatment on the iron and protein status in chronic renal failure patients under regular hemodialysis in Central Sudan L'effet du traitement oral par de la gomme arabe sur le statut martial et de protéinémie chez les patients en insuffisance rénale chronique sous hémodialyse régulière au Soudan centrale

Objective: To assess the effect of gum arabic (Acacia Senegal) oral treatment on the iron and protein status in chronic renal failure patients. Material and Methods: Thirty-six chronic renal failure (CRF) patients (under regular hemodialysis), and 10 normal subjects participated in this study. The patients were randomly allocated into the following groups: Group A (n=12): CRF patients under low protein diet (LPD) (less than 40 gram/day), and gum arabic (50 g/day) treatment; Group B (n=14): CRF patients under LPD, gum arabic, iron (ferrous sulphate 200 mg/day) and folic acid (5 mg/day) treatment; Group C (control group, n=10): CRF patients under LPD, iron and folic acid treatment; Group D (n=10): normal volunteers who were kept on normal diet beside a daily dose of 50 gm gum arabic. Each of the above treatments was continued for three consecutive months. Predialysis blood samples were collected from each subject before treatment, and twice per month for three months. Hemoglobin (Hb), hematocrit, total protein, albumin, globulin and 24-hour urine volume as well as serum iron, total iron-binding capacity (TIBC),transferrin saturation, packed cell volume (PCV) and, mean corpuscular hemoglobin concentration (MCHC) were determined. Results: Following administration of gum arabic oral treatment for three months, serum iron increased by 5.85% and 4.81% for groups A and B, respectively. These increases were significantly different from the baseline (P<0.05), and control group C (P<0.01). TIBC was significantly decreased in group A (4.44%) and in group B (4.31%) as compared with the baseline and control group C (P<0.05). Transferrin saturation was significantly increased by 7.77%, and 9.59% for groups A and B, respectively, compared with the baseline (P<0.05) and control group C (P<0.01). Hb, PCV, MCHC, serum total protein, albumin and globulin, and 24-hour urine volume showed no statistically significant differences from the baseline and control groups. Conclusion: The improvement in iron status due to oral administration of gum arabic could reduce the need for oral iron prescription. Résumé Objectif: D'évaluer l'effet du traitement oral par de la gomme arabe (acacia Sénégal) sur le statut martial et de protéinémie chez les patients en insuffisance rénale chronique sous hémodialyse régulière. Matériel et méthodes: Trente-six patients en insuffisance rénale chronique (CRF) (sous hémodialyse régulière), et 10 sujets normaux ont participé à cette étude. Les patients ont été aléatoirement assignés dans les groupes suivants : Groupe A (n=12): Les patients en CRF sous régime hypoproteiné (LPD) (moins de 40 gram/jour), et traitement par de la gomme arabe (50 g/j); Groupe B (n=14): Patients en CRF sous LPD, gomme arabe, fer (sulfate ferreux 200 mg/j) et acide folique (5 mg/j); Groupe C (groupe témoin, n=10): Patients en CRF sous LPD, fer et acide folique ; Groupe D (n=10): volontaires normaux qui ont été gardés sous régime normal près d'une dose quotidienne de go