Evaluation of oxidative stress after repeated intravenous iron supplementation

• Published in: Renal failure Vol. 27; no. 3; pp. 345 - 351
• Main Authors: MIMIC-OKA, Jasmina, SAVIC-RADOJEVIC, A, PLJESA-ERCEGOVAC, M, OPACIC, M, SIMIC, T, DIMKOVIC, N, SIMIC, D. V
• Format: Journal Article
• Language: English
• Published: Colchester Taylor & Francis 01.01.2005
• Subjects: Adult; Alcohol Oxidoreductases - blood; Anemia, Iron-Deficiency - blood; Anemia, Iron-Deficiency - drug therapy; Anemia, Iron-Deficiency - etiology; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biomarkers - blood; Drug Administration Schedule; Erythrocytes - metabolism; Female; Ferric Compounds - administration & dosage; Follow-Up Studies; Glutathione Peroxidase - blood; Humans; Immunoenzyme Techniques; Injections, Intravenous; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - complications; Lipid Peroxidation - drug effects; Lipid Peroxidation - physiology; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Oxidative Stress - drug effects; Oxidative Stress - physiology; Renal failure; Spectrophotometry; Superoxide Dismutase - blood; Transferrin - metabolism; Treatment Outcome; Kidney disease; transferrin saturation; Evaluation; Oxidative stress; Transferrin; Nephrology; Urinary system disease; Intravenous administration; Anemia; Enzyme; chronic renal failure; Saturation; Hemopathy; Iron; antioxidant enzymes; iron supplementation; Antioxidant; Chronic; Renal failure; Anesthesia; Supplementation; Resuscitation
• DOI: 10.1081/JDI-200056599
• ISSN: 0886-022X

Parenteral iron has been recommended for the treatment of iron deficiency in the majority of maintenance hemodialyzed (HD) patients. However, iron supplementation and consequent over saturation of transferrin and high iron levels, may aggravate oxidative stress already present in these patients. This study aimed to further clarify the role of repeated intravenous iron therapy as a supplementary cause of oxidative stress in HD patients. Markers of free radical activities (carbonyl reactive derivatives, CRD, thiol groups, SH, malondialdehyde, MDA) and antioxidant enzyme activities (superoxide dismutase, SOD and glutathione peroxidase, GPX) were determined in plasma and red blood cells (RBC) of 19 hemodialysis patients given a total iron dose of 625 mg (ferrogluconat, Ferrlecit, 62.5 mg). Blood samples were taken before the first and after the last dose of iron. Twenty apparently normal subjects served as healthy controls. Before iron treatment, HD patients exhibited increased concentrations of MDA and CRD in plasma and red blood cells, accompanied with impaired antioxidant capacity. All patients responded to iron therapy with a significant increase in their serum ferritin, serum iron, hemoglobin, and red blood cells levels. However, iron treatment resulted in enhanced oxidative stress in plasma of HD patients, since significant increase in plasma MDA and CRD concentrations, together with a decrease in nonprotein SH groups levels were detected. Supplementation with iron did not significantly influence plasma SOD and GPX activities, nor did any of the red blood cell parameters tested. Our data show that, despite improvement in hematological parameters, an increase in iron stores due to supplementation could also contribute to increased free radical production in HD patients.