THE EFFECTS OF INTRAVENOUS IRON TREATMENT ON OXIDANT STRESS AND ERYTHROCYTE DEFORMABILITY IN HEMODIALYSIS PATIENTS

Intravenous iron supleınentation is one of the important components of anemia threatment. Oxidant properties of free iron is well known, however data concerning effects of intravenous (IV) iron in hemodialysis (HD) patients on oxidant stress and erythrocyte deformability (EDEF), a measure of it, are conflicting. In the present study we aimed to evaluate the effects of I. V iron on oxidant stress and EDEF. Thirteen HD patients (10 males, 3 females, mean age: 49,92+13,41 years), administered iron intravenously, were enrolled into the study. All patient were underwent dialysis thrice, first without iron supplementation, 2 second with 20 mg iron supplementation and the last 100 mg iron supplementation. Iron HI hydroxide sucrose (Venofer®) was the medication used. In study periods, 7 blood samples were drawn from each patient: before dialysis, at the end of the dialysis, 15, 30, 60, 90 and 120 minutes after the in all three session with an exception that 15th minutes samples were not drawn in the session when 100 mg iron was administered since iron was given by infusion during the first 30 minutes of the 3rd HD session. As markers of oxidant stress EDEF and malondialdehyde (MDA) were studied in all samples. When the results of the session without iron were considered, bivariate correlatioan analysis did not reveal any correlation between MDA and EDEF. When the course of each parameter were considered seperately, plasma MDA levels 90 and 120 minutes after HD session were significantly higher than that of the before and just after the HD session (p<0.05). Whereas EDEF in 60, 90 and 120 minutes after HD session was found to be worsened when compared to before and just after HD sessions' values (p<0.05). When results of the session with 20 mg iron were considered, EDEF and MDA values were not found to be correlated and throughout the course, EDEF did not present any significant change whereas MDA levels 60, 90 and 120 minutes after HD session were found to be significantly higher than that of the 15 and 30 minutes after HD session (p<0.05). When results of the session with 100 mg iron were considered, MDA levels 30, 60, 90 and 120 minutes after HD session were found to be significantly higher than that of the before and just after the HD sessions' (p<0,05). EDEF in 120 minutes after HD session was increased. As a conclusion, in the present study, it was observed that intravenously administered iron in 20 and 100 mg doses did not cause additional deteriorating effect on oxidant stress however EDEF may be ameliorated by I. V iron.