Intravenous iron sucrose and oxidative stress in chronic kidney disease stage 4 and 5

Karanth, Suman and Prabhu, Ravindra and Bairy, Manohar and Nagaraju, Shankar Prasad and Bhat, Ashok and Kosuru, Srinivas and Parthasarathy, Rajeevalochana and Kamath, Shobha and Prasad, Hemanth K and Kallurwar, Kapil P (2014) Intravenous iron sucrose and oxidative stress in chronic kidney disease stage 4 and 5. Nephrology Dialysis Transplantation, 29 (3). pp. 145-146.

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Introduction and Aims: Intravenous iron has been postulated to increase oxidative stress in chronic kidney disease(CKD).We assessed the oxidant effect of intravenous (IV) iron sucrose in CKD stage 4 and 5 patients by estimating change in levels of highly sensitive C reactive protein (hsCRP), malondialdehyde (MDA) and myeloperoxidase (MPO) pre and post intravenous iron therapy. Methods: After obtaining clearance from the institutional ethics committee,we prospectively assessed change in levels of hsCRP,MDA and MPO prior to and 48 hours after a 100mg dose of intravenous iron sucrose in patients of CKD 4 and 5 with iron deficiency.Iron deficiency was diagnosed by either iron saturation(serum iron/total iron binding capacity) less than 20% or serum ferritin less than 200ng/L. Results were analysed on SPSS version 15.Wilcoxon signed rank test was used to compare mediansand a p value less than 0.05 was considered significant. Results: There were 32 patients in the study group with a mean age of 55.31 ± 12.18 years. The mean creatinine clearance was 16.69 ± 8.71 ml/min and the mean serum albumin was 3.54 ± 0.58 g/l.The mean iron saturation and serum ferritin were 23.8 ± 12.2 % and 134.2 ± 117.7 ng/L respectively. There was a significant increase in the levels of hsCRP (P = 0.005), MDA (p = 0.003), and MPO (p < 0.05) after IV iron therapy as shown in table 1. Conclusions:We observed an increased oxidative stress following intravenous iron in CKD stage 4 and 5.The clinical relevance of these findings and their effects need further study.

Item Type: Article
Subjects: Medicine > KMC Manipal > Biochemistry
Medicine > KMC Manipal > Medicine
Medicine > KMC Manipal > Nephrology
Depositing User: KMC Manipal
Date Deposited: 18 Jun 2014 10:55
Last Modified: 18 Jun 2014 10:55

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