Malindretos Pavlos, Sarafidis Pantelis A, Rudenco Igor, Raptis Vasilios, Makedou Kali, Makedou Areti, Grekas Dimirios M
Renal Unit, 1st Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece.
Am J Nephrol. 2007;27(6):572-9. doi: 10.1159/000107928. Epub 2007 Sep 5.
BACKGROUND/AIMS: 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.
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).
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.
We did not find an increase in the markers of oxidation/inflammation studied, after slow i.v. iron administration during hemodialysis session.
背景/目的：血液透析（HD）期间快速静脉注射铁剂与氧化应激增强及炎症生物标志物增加有关，而这些变化同样可由血液透析过程本身诱发。本研究旨在探讨缓慢静脉注射铁剂是否会加重血液透析过程中的氧化应激状态及炎症生物标志物水平。
选取20例年龄在30 - 92岁、铁储备充足且血红蛋白、转铁蛋白饱和度和血清铁蛋白值在推荐目标范围内的透析患者，在三个不同的血液透析疗程中进行评估。在第一个疗程中，患者未接受任何铁剂治疗，而在第二个和第三个疗程中，患者分别接受了100 mg蔗糖铁和100 mg右旋糖酐铁的缓慢静脉输注（60分钟）。在所有情况下，于血液透析疗程开始前、铁剂输注结束后15分钟及血液透析疗程结束时采集血样，用于检测氧化应激标志物（氧化型低密度脂蛋白和缺血修饰白蛋白）和炎症标志物（高敏C反应蛋白、白细胞介素-6和肿瘤坏死因子-α）。
血液透析期间氧化型低密度脂蛋白无显著变化，且在所研究的三种情况下这种模式相似。相比之下，缺血修饰白蛋白显著增加，且在单纯血液透析和铁剂输注情况下这种效应并无差异。血液透析期间高敏CRP、IL-6和TNF-α均显著升高，并且两种铁剂输注方式在这种模式下均未产生显著变化。
我们未发现血液透析期间缓慢静脉注射铁剂后所研究的氧化/炎症标志物增加。
Zotero 插件