The effects of iron treatment on viscosity in children with cyanotic congenital heart disease

Objective: This study was planned to determine the effects of iron treatment in children with cyanotic congenital heart disease. Method and Materials: A total of 39 patients with cyanotic congenital heart disease including 20 (51\%) females, 19 (49\%) males and whose mean age was 9.9 +/- 6.2 years, average weight was 33 +/- 18.4 kg were evaluated. Patients were categorized into two groups as having iron deficiency and no iron deficiency with respect to their ferritin levels. 4 mg/kg/day iron treatment with two valences was applied to the groups with iron deficiency for 3 months. Clinical and laboratory findings of both groups were assessed at the outset and 3 months later and viscosity measurements were carried out. Results: Iron deficiency was identified in 21 (53.8\%) out of 39 patients. Average Hb and Hct values following 3-month iron treatment increased from 14.8 +/- 2.4 g/dl to 16.0 +/- 2.0 (P = 0.003) and from \%45.8 +/- 7.5 to \%47.6 +/- 7.2 (P = 0.052), respectively. Average viscosity value, however, was 5.6 +/- 1.0 cP, it reduced to 5.5 +/- 1.0 cP value by demonstrating very little reduction (P = 0.741). Nevertheless, O-2 sat value increased from 71.7 to 75\% and complaints such as headache, visual blurriness, having frequent sinusitis decreased. Conclusions: It was observed that iron treatment increased Hb and Hct levels in patients with cyanotic congenital heart disease without raising viscosity and it ensured improvement in clinical symptoms

Effects of whole blood viscosity and plasma NOx on cardiac function and cerebral blood flow in children with chronic kidney disease

Background/aim: The aim of the study was to investigate the effects of whole blood viscosity and plasma nitric oxide on cerebral and cardiovascular risks associated with chronic kidney disease. Materials and methods: The study group consisted of 40 pediatric patients and 21 healthy control subjects. Hematologic and biochemical variables, viscosity and plasma nitric oxide levels, echocardiographic findings, and middle cerebral artery blood flow velocity were examined. Results: Viscosity values of patients were significantly lower than those of the control group. Lower values of hematocrit, total protein, and albumin and higher values of ferritin in all patient groups resulted in significantly low viscosity levels. Plasma nitric oxide levels were higher in all patient groups than those in the controls. No statistically significant difference was present in middle cerebral artery blood flow velocity between the patient and control groups. Even when systolic functions were normal, the patient group had significant deterioration in diastolic functions, suggesting morbidity and mortality risks. Conclusions: Cerebral blood flow velocities were not affected by viscosity and nitric oxide levels, suggesting that cerebral circulation has the ability to make adaptive modulation. The metabolism of nitric oxide levels needs further investigation and studies in patients with chronic renal disease