Iron-induced oxidative stress in haemodialysis patients: a pilot study on the impact of diabetes |
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Authors: | Ann Van Campenhout Christel Van Campenhout Albert Lagrou Begoña Manuel-y-Keenoy |
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Institution: | (1) Vascular Biology Unit, James Cook University, Townsville, Australia;(2) Clinical Biology, Federal Scientific Institute of Public Health, Brussels, Belgium;(3) Laboratory of Human Biochemistry, University of Antwerp, Antwerp, Belgium;(4) Metabolic Research Unit, University of Antwerp, campus Drie Eiken, T4.37, Universiteitsplein 1, Wilrijk-Antwerp, 2610, Belgium |
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Abstract: | Background: Administration of intravenous iron preparations in haemodialysis patients may lead to the appearance of non-transferrin
bound iron which can catalyse oxidative damage. We investigated this hypothesis by monitoring the oxidative stress of haemodialysis
patients and the impact of iron and diabetes mellitus herein. Materials and methods: Baseline values of serum iron and related proteins, transferrin glycation, non-transferrin bound iron, antioxidant capacity
and lipid peroxidation (malondialdehyde) of 11 haemodialysis patients (six non-diabetic and five type 2 diabetes) were compared
to those of non-haemodialysis control subjects (non-diabetic and type 2 diabetes). Changes in these parameters were monitored
during haemodialysis before and after iron administration. Results: Baseline values of malondialdehyde correlated with ferritin concentration (r = 0.664, P = 0.036) and were elevated to the same extent in non-diabetic and diabetic haemodialysis patients (median of 1.09 compared
to 0.60 μmol/l in control persons, P < 0.02). After iron infusion, transferrin saturation increased more markedly in non-diabetic subjects from 28% to 185% vs.
from 33% to 101% in diabetic patients (P = 0.008). This increase was accompanied by the appearance of non-transferrin bound iron (5.91 ± 1.33 μmol/l), a loss in plasma
iron-binding antioxidant capacity and a further increase in malondialdehyde which was more pronounced in diabetic patients
(from 0.93 ± 0.30 μmol/l to 2.21 ± 0.69 μmol/l vs. from 1.21 ± 0.42 μmol/l to 1.86 ± 0.56 μmol/l in the non-diabetic subjects,
P = 0.046). Conclusions: In haemodialysis patients, higher lipid peroxidation is determined by higher body iron stores. The increase induced by iron
infusion is accompanied by a loss in iron-binding antioxidant capacity and is more pronounced in diabetes mellitus. |
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Keywords: | Haemodialysis Iron Oxidative stress Diabetes |
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