Kidney Week

Abstract: TH-PO247

Oral Iron Administration (OIA) Transiently Increased Serum Malondialdehyde Modified Low-Density Lipoprotein (MDA-LDL) and Non-Transferrin Bound Iron (NTBI) in Hemodialysis (HD) Patients

Session Information

• Anemia and Iron Metabolism: Clinical
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Anemia and Iron Metabolism

• 202 Anemia and Iron Metabolism: Clinical

Authors

• Saito, Noriko, Shinraku-en Hospital, Niigata, Niigata, Japan

Noriko Saito,

• Saito, Kazuhide, Niigata University, Niigata, Niigata, Japan

Kazuhide Saito,

• Morioka, Tetsuo, Shinraku-en Hospital, Niigata, Niigata, Japan

Tetsuo Morioka,

• Shimada, Hisaki, Shinraku-en Hospital, Niigata, Niigata, Japan

Hisaki Shimada,

• Ikuta, Katsuya, Asahikawa Medical University, Asahikawa, Japan

Katsuya Ikuta,

• Kohgo, Yutaka, International University of Health and Welfare, Nasushiobara, Japan

Yutaka Kohgo,

• Miyazaki, Shigeru, Shinraku-en Hospital, Niigata, Niigata, Japan

Shigeru Miyazaki,

Background

Intravenous iron administration may increase NTBI which appears in iron overload and cause organ damage through free radical production.OIA is not considered to increase NTBI because of slow iron adsorption rate. Aim of this study is to assess the kinetics of transferrin saturation(TSAT), NTBI and MDA-LDL in HD patients after OIA.

Methods

16 HD patients without any iron load within 4 weeks, whose Hb<12g/dl, ferritin<100ng/ml and CRP<1.0mg/dl and 8 healthy volunteers were enrolled.Both groups received oral ferrous sulfate 105mg.
We evaluated the following markers before and at 1,2,3,4 and 48 hours(hrs) after OIA : MDA-LDL, NTBI, Hepcidin-25(HPC), serum iron(Fe), TSAT, ferritin and standard hematological parameters. Vitamin C(VC) and selenium(Se) were measured before and 48hrs.
Other 9 HD patients without OIA were also enrolled as HD control.
MDA-LDL was measured by ELISA. NTBI was measured by recently described reliable method(Clin Chim Acta437:129-135, 2014).

Results

1. Fe before OIA was 30(24-49)µg/dl and significantly increased at 1hr and reached the peak level of 272(104-320)µg/dl at 4hrs (medians(interquartile range)).
2. MDA-LDL before OIA was 97(68-124)U/L and significantly increased to 116(73-166)U/L at 1hr and reached the peak level of 121(81-165)U/L at 3hrs and decreased to 117(79-134)U/L at 48hrs, not significantly different from the level before OIA.
3. TSAT before OIA was 12(7-17)% and significantly increased at 2hrs, reached the peak level of 70(34-80)% at 4hrs.
4. NTBI before OIA was 0.02(0-0.10)µM and significantly increased to 0.15(0.03-0.56) µM at 4hrs.
5. HPC before OIA was very low (0.55(0.14-1.78)ng/ml) and unchanged during 48hrs.
6. In healthy and HD controls Fe, MDA-LDL, TSAT, NTBI and HPC were not significantly changed during 48hrs.
7. VC before OIA in HD patients was 3.0(1.8-6.2)mg/ml and significantly lower than that in healthy volunteers (7.7(6.5-10.7) mg/ml).
8. Se before OIA in HD patients was 14.5(12.5-16.1) mg/dl and significantly lower than that in healthy volunteers (18.4(17.6-20.3) mg/dl).

Conclusion

Fe and MDA-LDL at 1hr, TSAT at 2hrs, and NTBI at 4hrs significantly increased after OIA in HD patients. The lower anti-oxidant level in HD patients may influence the early increase of MDA-LDL.

Funding

• Private Foundation Support