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Published on: March 14, 2017
Effect of intravenous iron sucrose on oxidative stress in peritoneal dialysis patients
Funda Saglam1, Caner Cavdar, Sezer Uysal
1Department of Nephrology, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
Insights
Intravenous iron-sucrose at 100 mg showed no acute adverse effects on antioxidant enzymes or oxidative stress markers in continuous ambulatory peritoneal dialysis patients. This iron dose appears safe for CAPD patients with adequate iron stores.
Area of Science:
- Nephrology
- Biochemistry
- Oxidative Stress Research
Background:
- Intravenous iron is standard for dialysis patients.
- Oxidative stress is noted in hemodialysis patients on iron, but data for CAPD patients is lacking.
Purpose of the Study:
- To assess the impact of 100 mg intravenous iron-sucrose on erythrocyte antioxidant enzymes (SOD, CAT, GSHPx) and plasma malondialdehyde (MDA) in CAPD patients.
Main Methods:
- 12 CAPD patients received 100 mg iron-sucrose infusion.
- Blood samples were analyzed for iron, ferritin, hsCRP, RBC antioxidant enzymes (SOD, CAT, GSHPx), and plasma MDA before, during, and after infusion.
Main Results:
- Plasma iron and transferrin saturation increased significantly post-infusion.
- No significant changes were observed in erythrocyte SOD, CAT, GSHPx, or plasma MDA.
- Higher baseline ferritin levels correlated with increased MDA at 60 minutes.
Conclusions:
- A 100 mg dose of intravenous iron-sucrose does not cause acute harm in CAPD patients with sufficient iron levels.
- This iron dosage can be safely administered to CAPD patients.
Aim:
Intravenous iron therapy is an accepted treatment for patients receiving hemodialysis and continuous ambulatory peritoneal dialysis (CAPD). Studies have found enhanced oxidative stress in hemodialysis patients receiving intravenous iron, but there are no clinical data for CAPD patients. The aim of the current study was to investigate the effect of 100 mg of intravenous iron-sucrose on the erythrocyte (RBC) antioxidant enzymes (namely, superoxide dismutase [SOD], catalase [CAT], and glutathione peroxidase [GSHPx]) and plasma malondialdehyde (MDA), an oxidant molecule, in CAPD patients.
Methods:
Twelve CAPD patients receiving maintenance intravenous iron-sucrose were recruited. After a 12-hour fast, blood samples were taken for hemoglobin, iron, ferritin, and high-sensitivity C-reactive protein (hsCRP), and for baseline activities of erythrocyte antioxidant enzymes (i.e., SOD, CAT, GSHPx) and the plasma oxidant molecule, MDA. 100 mg iron-sucrose was infused over 30 minutes. Blood samples taken during (i.e., 15 minutes after commencement of infusion) and after (i.e., at 30 minutes, 60 minutes, and 6 hours after commencement) the infusion were taken for measurement of plasma iron, ferritin, TSAT, RBC SOD, CAT, GSHPx, and plasma MDA.
Results:
Plasma iron and transferrin saturation elevated significantly during infusion (p < 0.05). There was no significant change in erythrocyte SOD, CAT, GSHPx, or in MDA activities. There was a reduction of GSHPx activity at the 30th minute (from 153.69 +/- 66.69 to 123.68 +/- 25.50 mU/mL), but it was not statistically significant. The patients were grouped according to baseline ferritin (100-400 and 400-800 ng/mL); 60th-minute MDA was significantly higher in the latter group (p < 0.05). There was no correlation between hsCRP and oxidant-antioxidant balance. No correlation was noted between RBC antioxidant enzymes or plasma oxidant molecule and ferritin levels.
Conclusion:
There are no acute deteriorating effects from a 100 mg of intravenous iron-sucrose in CAPD patients with optimal iron stores. This dose may be applied safely in CAPD patients.
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