Slow intravenous iron administration does not aggravate oxidative stress and inflammatory biomarkers during hemodialysis: a comparative study between iron sucrose and iron dextran.
OBJECTIVE
Fast intravenous (i.v.) iron administration during hemodialysis (HD) is associated with the augmentation of oxidative stress and the increase in inflammatory biomarkers, which are also induced by the hemodialysis procedure itself. The aim of this study was to investigate if slow i.v. iron administration would aggravate the status of oxidative stress and inflammatory biomarkers during a hemodialysis session.


METHODS
Twenty dialysis patients 30-92 years of age that were iron replete and had values for hemoglobin, transferrin saturation and serum ferritin among recommended goals were evaluated in three separate hemodialysis sessions. In the first session patients did not receive any iron treatment, whereas during the second and the third session patients received slow (60 min) i.v. infusions of 100 mg of iron sucrose and 100 mg of iron dextran, respectively. Blood samples were drawn before the hemodialysis session, 15 min after the end of iron administration and at the end of the hemodialysis session in all occasions, for the measurement of markers of oxidant stress (oxidized LDL and ischemia-modified albumin) and inflammation (high-sensitivity C-reactive protein, interleukin-6 and tumor necrosis factor-alpha).


RESULTS
Oxidized LDL was not significantly altered during hemodialysis and this pattern was similar between the three occasions studied. In contrast, ischemia-modified albumin was significantly increased and this effect was also not different between the net hemodialysis and the occasions of iron administration. High-sensitivity CRP, IL-6 and TNF-alpha were all significantly elevated during hemodialysis and again both types of iron administration did not produce significant changes in this pattern.


CONCLUSIONS
We did not find an increase in the markers of oxidation/inflammation studied, after slow i.v. iron administration during hemodialysis session.
Malindretos
Pavlos
P
Renal Unit, 1st Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece. malindre@med.auth.gr
Sarafidis
Pantelis A
PA
Rudenco
Igor
I
Raptis
Vasilios
V
Makedou
Kali
K
Makedou
Areti
A
Grekas
Dimirios M
DM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000209:etiology; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D007262:Infusions, Intravenous / Q000379:methods; D015850:Interleukin-6 / Q000097:blood; D007505:Iron-Dextran Complex / Q000008:administration & dosage*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000097:blood