Review Article

Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin as an Adjunctive Therapy

Volume: 8 August 28, 2026

Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin as an Adjunctive Therapy

Abstract

Objective: Chronic kidney disease (CKD)-associated anemia is substantially driven by chronic inflammation, which promotes hepcidin upregulation, restricts iron availability, and impairs erythropoiesis. Conventional therapies, including erythropoiesis-stimulating agents and iron supplementation, primarily address erythropoietin deficiency and iron depletion but do not directly target the underlying inflammatory pathways. This narrative review evaluates the role of inflammation in CKD-associated anemia and examines the emerging potential of lactoferrin as an adjunctive therapeutic approach.

Methods: This narrative review was based on a literature search of PubMed, Scopus, and Google Scholar for articles published between January 2000 and March 2026, using combinations of the terms “chronic kidney disease,” “anemia,” “inflammation,” “hepcidin,” and “lactoferrin.”

Results: Chronic inflammation contributes to CKD-associated anemia through interleukin-6-mediated hepcidin upregulation, ferroportin degradation, impaired iron absorption and mobilization, and cytokinemediated suppression of erythropoiesis. Lactoferrin, an iron-binding glycoprotein with anti-inflammatory, immunomodulatory, and iron-regulatory properties, may counter these mechanisms by reducing inflammatory signaling, modulating hepcidin expression, and improving functional iron availability. Clinical studies have generally reported improvements in hemoglobin, with several studies also reporting favorable changes in hepcidin levels and inflammatory markers, supporting the potential anti-inflammatory and iron-regulatory effects of lactoferrin.

Conclusion: Lactoferrin represents a promising adjunctive approach for inflammation-driven CKD-associated anemia, particularly functional iron deficiency. Its potential effects on the IL-6–hepcidin–ferroportin axis may complement established ESA and iron therapy.

Keywords

References

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Details

Primary Language

English

Subjects

Nefroloji

Journal Section

Review Article

Publication Date

August 28, 2026

Submission Date

June 22, 2026

Acceptance Date

August 15, 2026

Published in Issue

Year 2026 Volume: 8

APA
Shah, H. J., Pariyani, J. K., Shinde, K. V., Pandya, D. P., Dave, B. A., & Lokhande, M. M. (2026). Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin as an Adjunctive Therapy. Turkish Journal of Internal Medicine, 8, 148-163. https://doi.org/10.46310/tjim.1976160
AMA
1.Shah HJ, Pariyani JK, Shinde KV, Pandya DP, Dave BA, Lokhande MM. Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin as an Adjunctive Therapy. Turk J Int Med. 2026;8:148-163. doi:10.46310/tjim.1976160
Chicago
Shah, Harsh J, Jacky K Pariyani, Kalyani V Shinde, Dharmil P Pandya, Bhakti A Dave, and Megha M Lokhande. 2026. “Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin As an Adjunctive Therapy”. Turkish Journal of Internal Medicine 8 (August): 148-63. https://doi.org/10.46310/tjim.1976160.
EndNote
Shah HJ, Pariyani JK, Shinde KV, Pandya DP, Dave BA, Lokhande MM (August 1, 2026) Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin as an Adjunctive Therapy. Turkish Journal of Internal Medicine 8 148–163.
IEEE
[1]H. J. Shah, J. K. Pariyani, K. V. Shinde, D. P. Pandya, B. A. Dave, and M. M. Lokhande, “Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin as an Adjunctive Therapy”, Turk J Int Med, vol. 8, pp. 148–163, Aug. 2026, doi: 10.46310/tjim.1976160.
ISNAD
Shah, Harsh J - Pariyani, Jacky K - Shinde, Kalyani V - Pandya, Dharmil P - Dave, Bhakti A - Lokhande, Megha M. “Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin As an Adjunctive Therapy”. Turkish Journal of Internal Medicine 8 (August 1, 2026): 148-163. https://doi.org/10.46310/tjim.1976160.
JAMA
1.Shah HJ, Pariyani JK, Shinde KV, Pandya DP, Dave BA, Lokhande MM. Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin as an Adjunctive Therapy. Turk J Int Med. 2026;8:148–163.
MLA
Shah, Harsh J, et al. “Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin As an Adjunctive Therapy”. Turkish Journal of Internal Medicine, vol. 8, Aug. 2026, pp. 148-63, doi:10.46310/tjim.1976160.
Vancouver
1.Harsh J Shah, Jacky K Pariyani, Kalyani V Shinde, Dharmil P Pandya, Bhakti A Dave, Megha M Lokhande. Targeting Inflammation in CKD-Related Anemia: The Emerging Role of Lactoferrin as an Adjunctive Therapy. Turk J Int Med. 2026 Aug. 1;8:148-63. doi:10.46310/tjim.1976160

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