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NDT Advance Access originally published online on November 26, 2007
Nephrology Dialysis Transplantation 2008 23(2):665-672; doi:10.1093/ndt/gfm588
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org


Oxidative stress and ferritin levels in haemodialysis patients

Emel Senol1, Alpaslan Ersoy1, Selda Erdinc2, Emre Sarandol2 and Mustafa Yurtkuran1

1Department of Nephrology and 2Department of Biochemistry, Uludag University Medical School, Bursa, Turkey

Correspondence to: Dr A. Ersoy, Department of Nephrology, Uludag University Medical School, 16059 Gorukle/Bursa, Turkey. Email: alpersoy{at}uludag.edu.tr



  Abstract

Background. Increased oxidative stress (OS) and inflammation are associated with atherosclerotic coronary artery disease in haemodialysis (HD) patients. Ferritin may have other effects in addition to its role in storing intracellular iron. This study was performed to determine any relationships between markers of OS, nutrition and inflammation in HD patients with normal and high ferritin levels.

Methods. Our cohort comprised 34 maintenance dialysis patients on erythropoietin therapy and 22 healthy controls. HD patients were divided into two groups: 17 with normal (<800 ng/ml) and 17 with high (>800 ng/ml) ferritin levels, and we measured lipid profile, albumin, highly sensitive C-reactive protein (hsCRP), anti-oxidant enzymes [whole blood glutathione peroxidase (Gpx), serum superoxide dismutase (SOD), paraoxonase, arylestherase (AE) and total anti-oxidant status (TAOC)], anti-oxidants (vitamin C) and lipid peroxidation products [red blood cell malondialdehyde (RBC MDA)].

Results. Compared with controls, the HD patients had higher serum urea, blood pressure, triglyceride, hsCRP, RBC MDA, SOD and TAOC values and lower albumin, low-density lipoprotein cholesterol, apolipoprotein AI, paraoxonase, AE and whole blood Gpx activities. Serum vitamin C, uric acid, apolipoprotein B, total- and high-density lipoprotein cholesterol, apolipoprotein B MDA, and lymphocyte levels in the HD patients with normal and high ferritin levels were similar. The OS markers of HD patients did not differ, whether or not they received intravenous iron supplementation or had transferrin saturations <50% or ≥50%.

Conclusion. HD patients are in a higher oxidative state, which results in the reduction of total anti-oxidant capacity and also have an increased inflammation status. We could not find a relationship between ferritin level and OS markers in HD patients receiving erythropoietin.

Keywords: erythropoietin; ferritin; haemodialysis; inflammation; nutrition; oxidative stress

Received for publication: 30. 1.07
Accepted in revised form: 2. 8.07


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