Polyglucose dialysis solution influences serum iron parameters

Owing to the lack of data dealing with the influence of polyglucose dialysis solution (PG-DS) on serum indicators of iron status, our study aimed at examining this problem in patients receiving PG-DS for the overnight exchange during treatment with continuous ambulatory peritoneal dialysis. We evaluated serum concentrations of iron, ferritin, and transferrin, total iron binding capacity (TIBC), and transferrin saturation (TSAT) at 1.6 +/- 0.8 months before introducing 7.5% PG-DS for an overnight 2 L exchange lasting about 10 hours (period I, n = 14), after 1.2 +/- 0.6 months of PG-DS administration (period II, n = 14), after 4.4 +/- 0.8 months of PG-DS administration (period III, n = 11), after 8.8 +/- 2.2 months of PG-DS administration (period IV, n = 9), and at 2.0 +/- 0.6 months after PG-DS discontinuation (period V, n = 11). Interference owing to PG-DS in laboratory determinations of serum iron parameters was excluded. Indices of nutritional status were also evaluated in all study periods. Significant differences in iron parameters were seen between periods I and III, or I and IV for transferrin (212 +/- 41 mg/dL vs 253 +/- 36 mg/dL), TIBC (304 +/- 40 micrograms/dL vs 338 +/- 31 micrograms/dL) and TSAT (34% +/- 15% vs 24% +/- 4%). After PG-DS withdrawal, these parameters all returned to pre-treatment values. Improvement in nutritional status was indicated by increases in total body mass (73.9 +/- 15.6 kg vs 77.4 +/- 13.8 kg), lean body mass (54.5 +/- 9.7 kg vs 56.9 +/- 8.5 kg), and serum total protein concentration (61.7 +/- 10.8 g/L vs 70.5 +/- 8.0 g/L). We conclude that serum transferrin concentration increases during PG-DS administration without enhanced iron binding to transferrin. An increase in transferrin level can be related to improved nutritional status.