NDT Advance Access originally published online on October 5, 2004
Nephrology Dialysis Transplantation 2004 19(12):3112-3116; doi:10.1093/ndt/gfh508
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Nephrol Dial Transplant Vol. 19 No. 12 © ERA-EDTA 2004; all rights reserved
Original Article
The influence of hepatitis C and iron replacement therapy on plasma pentosidine levels in haemodialysis patients
1 Faculdade Evangélica de Medicina do Paraná-Brazil, 2 Pontificia Universidade Catolica do Paraná-Brazil, 3 Post-Graduation Nephrology Program of Universidade Federal do Rio Grande do Sul-Brazil and 4 Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
Correspondence and offprint requests to: Bengt Lindholm, MD, PhD, Baxter Novum and Renal Medicine, Department of Clinical Science, Karolinska Institutet, K-56 Karolinska University Hospital Huddinge, S-141 86 Stockholm, Sweden. Email: bengt.lindholm{at}klinvet.ki.se
Background. Chronic liver disease and intravenous (i.v.) iron therapy can enhance oxidative stress. The aim of this study was to assess the influence of hepatitis C virus (HCV) and i.v. iron administration on oxidative stress in chronic haemodialysis (HD) patients.
Methods. A total of 115 HD patients (47% males, age 47±13 years) were placed in two groups according to the presence (HCV+) or absence (HCV–) of serum antibodies against HCV. Plasma pentosidine, high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and alanine aminotransferase (ALT) levels were measured. The patients were also analysed according to the tertiles of serum levels of ferritin: group 1 (ferritin <380 ng/ml), group 2 (ferritin 380–750 ng/ml) and group 3 (ferritin >750 ng/ml). The cumulative iron dose was recorded during 6 months prior to the study.
Results. HCV+ patients had significantly higher levels of plasma pentosidine and ALT than HCV– patients. Age, gender, serum albumin, IL-6 and hsCRP did not differ according to HCV serology. The levels of pentosidine were related to the ferritin levels and were significantly higher in group 3 compared with group 1. Moreover, the cumulative dose of iron was significantly higher in group 3 than in group 1. Plasma pentosidine showed a positive correlation with age, HCV and ferritin. In a stepwise backward multiple regression model, age and HCV were independent predictors of pentosidine levels.
Conclusion. HCV in HD patients is associated with increased pentosidine levels, possibly reflecting increased oxidative stress. The association between pentosidine and ferritin levels may suggest an impact of i.v. iron therapy.
Keywords: ferritin; haemodialysis; hepatitis C; oxidative stress; pentosidine