Iron sucrose induced morphological and functional changes in the rat kidney

Area of Science:

• Nephrology
• Pharmacology
• Toxicology

Background:

• Anemia in uremic patients necessitates erythropoietin and iron supplementation.
• Intravenous iron is preferred due to impaired gastrointestinal absorption in renal insufficiency.
• Systemic side effects of intravenous iron compounds warrant investigation into their renal impact.

Purpose of the Study:

• To investigate the effects of chronic iron sucrose exposure on renal function and morphology in a rat model.
• To assess potential dose-dependent renal changes associated with intravenous iron supplementation.

Main Methods:

• Male Wistar rats received intraperitoneal iron sucrose (1 mg/kg or 10 mg/kg) or dialysis fluid (control) every 4 days for 28 days.
• Renal function was evaluated before and after the treatment period.
• Kidney morphology was assessed post-treatment, focusing on glomerular and peritubular changes.

Main Results:

• Chronic iron sucrose administration increased PAS-positive material in glomeruli and collagen in the peritubular area in a dose-dependent manner.
• A significant decrease in renal urea clearance (53%) was observed at the highest iron sucrose dose (10 mg/kg bw).
• Morphological kidney changes were noted, but significant functional impairment was only evident at the highest dose.

Conclusions:

• Chronic exposure to iron sucrose induces morphological alterations in rat kidneys.
• Mild renal function impairment, specifically reduced urea clearance, may occur at high doses of iron sucrose.
• Further research is needed to fully elucidate the long-term renal safety profile of intravenous iron sucrose in uremic patients.