The influence of hepatitis C and iron replacement therapy on plasma pentosidine levels in haemodialysis patients.
BACKGROUND
Chronic liver disease and intravenous (i.v.) iron therapy can enhance oxidative stress. The aim of this study was to assess the influence of hepatitis C virus (HCV) and i.v. iron administration on oxidative stress in chronic haemodialysis (HD) patients.


METHODS
A total of 115 HD patients (47% males, age 47 +/- 13 years) were placed in two groups according to the presence (HCV(+)) or absence (HCV(-)) of serum antibodies against HCV. Plasma pentosidine, high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and alanine aminotransferase (ALT) levels were measured. The patients were also analysed according to the tertiles of serum levels of ferritin: group 1 (ferritin <380 ng/ml), group 2 (ferritin 380-750 ng/ml) and group 3 (ferritin >750 ng/ml). The cumulative iron dose was recorded during 6 months prior to the study.


RESULTS
HCV(+) patients had significantly higher levels of plasma pentosidine and ALT than HCV(-) patients. Age, gender, serum albumin, IL-6 and hsCRP did not differ according to HCV serology. The levels of pentosidine were related to the ferritin levels and were significantly higher in group 3 compared with group 1. Moreover, the cumulative dose of iron was significantly higher in group 3 than in group 1. Plasma pentosidine showed a positive correlation with age, HCV and ferritin. In a stepwise backward multiple regression model, age and HCV were independent predictors of pentosidine levels.


CONCLUSIONS
HCV in HD patients is associated with increased pentosidine levels, possibly reflecting increased oxidative stress. The association between pentosidine and ferritin levels may suggest an impact of i.v. iron therapy.
Faculdade Evangélica de Medicina do Paraná-Brazil.
Marcelo M
MM
Nascimento
Mohamed E
ME
Suliman
Annette
A
Bruchfeld
Shirley Y
SY
Hayashi
Roberto C
RC
Manfro
Abdul Rashid
AR
Qureshi
Roberto
R
Pecoits-Filho
Maria A
MA
Pachaly
Luciana
L
Renner
Peter
P
Stenvinkel
Miguel C
MC
Riella
Bengt
B
Lindholm
D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood*; D005260:Female; D005293:Ferritins / Q000097:blood; D006526:Hepatitis C / Q000097:blood*; D006801:Humans; D007501:Iron / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008239:Lysine / Q000031:analogs & derivatives* / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D006435:Renal Dialysis
D005293:Ferritins; D001120:Arginine; C062187:pentosidine; D007501:Iron; D008239:Lysine