The effect of different doses and types of intravenous iron on oxidative stress and inflammation in hemodialysis patients

Kumbasar, Abdülbaki; Gürsu, Meltem; Kaya, Cagdas; Öztürk, Savaş; Ergen, Abdulkadir; Kemik, Ahu Sarbay; Aydın, Zeki; Uzun, Sami; Karadağ, Serhat; Kazancıoğlu, Rümeyza

doi:10.5301/jn.5000072

Cited by 10 publications

(3 citation statements)

References 43 publications

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“…This may be explained by formation of hydroxyl radicals which are more toxic than superoxide and hydrogen peroxide. 6,7,15 There was no significant correlation of AOPP levels with iron and ferritin levels in our study. Drueke et al 15 detected previously a significant correlation between AOPP and ferritin.…”

Section: Discussioncontrasting

confidence: 63%

“…AOPP levels increase in hemodialysis (HD) patients especially in conjunction with inflammation and iron treatment. 6,7 Iron in the treatment dose causes increase in the serum free iron which in turn converts into hydroxyl radical by reacting with hydrogen peroxide through phenton reaction. 8 There is chronic inflammation in most of the HD patients.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Relationship Between Advanced Oxidation end Products and Inflammatory Markers in Maintenance Hemodialysis Patients

Aydın

Karadağ

Öztürk

et al. 2019

JNA

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Introduction Increased oxidative stress and blunted anti-oxidant mechanisms are important problems in hemodialysis (HD) patients. Reactive oxygen species (ROS) act directly on proteins, leading to the formation of oxidized amino acids. Advanced oxidation protein products (AOPP) are among these substances. Many oxidant substances increase the level of AOPP. Iron is an element with strong oxidant capacity, especially when used intravenously. It is thought that iron treatment further increases the oxidative stress in HD patients. We aimed to investigate the relationship between AOPP and inflammatory status in HD patients. Materials and Methods Patients who were on maintenance HD program without additional co-morbidities and no history of use of intravenous iron within the last two weeks were recruited in the study. The blood samples taken just before the dialysis session were analyzed for AOPP, serum iron, total iron binding capacity (TIBC), ferritin, C-reactive protein (CRP), ß2-microglobulin, fibrinogen, interleukin (IL)-1, IL-6 and tumor necrosis factor-α levels besides routine biochemical measurements and complete blood count. Results The number of patients included in the study was 102 (n: 53 female, %52.0) and the mean age was 47.6±13.9 years. The mean transferrin saturation was 25.4%. AOPP levels, iron use in patients was higher compared to patients who do not use (respectively 2.58±0.19 mmol/l and 2.50 ±0.16mmol/l, p = 0.046). We did not detect statistically significant correlation of AOPP levels with iron parameters and other inflammatory markers. Conclusion The present study showed that intravenous iron therapy does not increase oxidative stress. Although serum AOPP level was higher in patients on intravenous iron treatment, it was not correlated with iron indices and inflammatory markers. So, intravenous iron may exert its oxidant effect free from serum iron indices.

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Section: Discussioncontrasting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Evaluation of the Relationship Between Advanced Oxidation end Products and Inflammatory Markers in Maintenance Hemodialysis Patients

Aydın

Karadağ

Öztürk

et al. 2019

JNA

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“…There is limited evidence showing that increased iron stores and high-dose intravenous (IV) iron therapy may create oxidative stress (OS) in haemodialysis (HD) patients [ 34 , 35 ]. However, the minimum level of serum ferritin to induce oxidative tissue damage is unknown [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Serum paraoxonase 1 activity in patients with iron deficiency anemia

Okuturlar¹,

Gedikbaşı²,

Akalın³

et al. 2016

aoms

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IntroductionIn this study we aimed to detect paraoxonase 1 (PON-1) activity in iron deficiency anemia (IDA) and to compare it with healthy controls by observing the change after iron therapy.Material and methodsIn this study, 50 adult patients with IDA and 40 healthy subjects were enrolled. All patients were analyzed at the beginning and after treatment according to laboratory assessments.ResultsMean paraoxonase and arylesterase activities in the iron deficiency anemia group were significantly lower than mean activities of the control group (102.4 ±19.2 U/l and 163.3 ±13.68 U/l, respectively and 157.3 ±26.4 U/l and 256.1 ±24.6 U/l, respectively; p = 0.0001 for both). Paraoxonase and arylesterase activities significantly increased after treatment for IDA (143.2 ±13.9 and 197.6 ±27.9 U/l, respectively, p = 0.0001). Mean activities after treatment with iron were significantly lower than mean activities in the control group (p = 0.002; p = 0.0001 respectively).ConclusionsParaoxonase and arylesterase activities in patients with IDA significantly increased after treatment with iron therapy. In adults IDA may also be one of the factors associated with increased risk of atherosclerosis.

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Redox Regulation of Inflammation: Old Elements, a New Story

Wang

Deng

et al. 2014

Medicinal Research Reviews

143

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Inflammation is an essential immune response characterized by pain, swelling, redness, heat, and impaired function. A controlled acute inflammatory response is necessary to fight off infection and overcome injury. However, if the inflammatory process persists and enters into the chronic state, it can lead to local and systemic deleterious effects counterproductive to healing and instead constitutes a new pathology. Typically, inflamed tissues are associated with an elevated level of reactive species (reactive oxygen species (ROS)/reactive nitrogen species (RNS)). These ROS/RNS are generated during the respiratory burst of immune cells and are important factors in defense against invading pathogens. Additionally, reactive species are now known to trigger oxidative/nitrosative modifications of biomolecules. While most of these modifications lead to irreparable damage, some are subtle and fully reversible. The reversible modifications can initiate signaling cascades known as "redox signaling." This redox signaling tightly modulates the inflammatory response. Thus, understanding the complex role of ROS/RNS-induced redox signaling in inflammation will assist in the design of relevant therapeutic intervention strategies for inflammation-associated diseases. This review will highlight the impact of oxidative stress and redox signaling on inflammation and inflammation-associated diseases, with a focus on redox modifications of inflammation-related proteins.

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The effect of different doses and types of intravenous iron on oxidative stress and inflammation in hemodialysis patients

Abstract: The different types and doses (intermittent or once monthly total dose) of IVI treatments are well tolerated without negative effects on the markers of lipid and protein oxidation and inflammatory indices in chronic HD patients.

Cited by 10 publications

References 43 publications

Evaluation of the Relationship Between Advanced Oxidation end Products and Inflammatory Markers in Maintenance Hemodialysis Patients

Evaluation of the Relationship Between Advanced Oxidation end Products and Inflammatory Markers in Maintenance Hemodialysis Patients

Serum paraoxonase 1 activity in patients with iron deficiency anemia

Redox Regulation of Inflammation: Old Elements, a New Story

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