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NDT Advance Access published online on October 5, 2004
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh508
© 2004 by European Renal Association - European Dialysis and Transplant Association
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Received June 12, 2003
Accepted August 31, 2004

Original Articles

The influence of hepatitis C and iron replacement therapy on plasma pentosidine levels in haemodialysis patients

Marcelo M. Nascimento 1, Mohamed E. Suliman 2, Annette Bruchfeld 2, Shirley Y. Hayashi 2, Roberto C. Manfro 3, Abdul Rashid Qureshi 2, Roberto Pecoits-Filho 4, Maria A. Pachaly 5, Luciana Renner 5, Peter Stenvinkel 2, Miguel C. Riella 6, and Bengt Lindholm 2*

1 Faculdade Evangélica de Medicina do Paraná-Brazil; Post-Graduation Nephrology Program of Universidade Federal do Rio Grande do Sul-Brazil; Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Karolinska Institutet, Stockholm, Sweden
2 Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Karolinska Institutet, Stockholm, Sweden
3 Post-Graduation Nephrology Program of Universidade Federal do Rio Grande do Sul-Brazil
4 Pontificia Universidade Catolica do Paraná-Brazil; Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Karolinska Institutet, Stockholm, Sweden
5 Faculdade Evangélica de Medicina do Paraná-Brazil
6 Faculdade Evangélica de Medicina do Paraná-Brazil; Pontificia Universidade Catolica do Paraná-Brazil

* To whom correspondence should be addressed. E-mail: bengt.lindholm{at}klinvet.ki.se.



  Abstract

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.
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