%0 Journal Article
%T Effect of ¦Á-Lipoic Acid on Oxidative Stress in End-Stage Renal Disease Patients Receiving Intravenous Iron
%A Arif Showkat
%A William R. Bastnagel
%A Joanna Q. Hudson
%J ISRN Nephrology
%D 2014
%R 10.1155/2014/634515
%X Oxidative stress is associated with increased risk of cardiovascular disease in end-stage renal disease (ESRD) patients. Intravenous (IV) iron has been shown to increase oxidative stress. The aim of the study was to evaluate changes in oxidative stress markers following administration of IV sodium ferric gluconate (SFG) to ESRD patients with and without administration of the antioxidant, ¦Á-lipoic acid. This is an open-label, crossover study. 125£¿mg of IV SFG was administered during control (C) and intervention (I) visits. During the I visit, 600£¿mg of ¦Á-lipoic acid was given orally prior to IV SFG. Blood samples were collected at defined time periods for F2-isoprostane (FIP), lipid hydroperoxide (LHP), malondialdehyde (MDA), and iron indices. We recruited ten African-American ESRD subjects: 50% male; mean age years; mean hemoglobin £¿g/dL; ferritin £¿ng/mL; transferrin saturation %. There were no significant differences in iron indices between the two visits after IV SFG. MDA, FIP, and LHP increased significantly for both C and I visits with a greater increase in the I group. Administration of IV SFG results in an acute rise in oxidative stress in ESRD patients. In contrast to previous studies, administration of ¦Á-lipoic acid was associated with a greater increase in oxidative stress. 1. Introduction Patients with end-stage renal disease (ESRD) on hemodialysis (HD) have very high cardiovascular mortality [1]. Interestingly, the usual risk factors for atherosclerotic diseases in the general population fail to explain the increased cardiovascular mortality in the HD population. For example, unlike the general population, mild-to-moderate elevation of cholesterol or blood pressure does not correlate with increased atherosclerotic complications or mortality in HD patients. As a result, several nontraditional uremia-related risk factors have been considered, including elevated levels of oxidative stress [1, 2]. Intravenous (IV) iron administration has become an integral part of anemia management in ESRD patients; however, exposure to IV iron is among the factors associated with the increase in oxidative stress in the dialysis patients [3¨C6]. Whether chronic exposure to low maintenance doses of IV iron increases the risk of cardiovascular events has yet to be determined. The oxidative stress markers, malondialdehyde (MDA), lipid hydroperoxide (LHP), and F2 isoprostane (FIP), represent products formed by the reactive oxygen species generated following administration of IV iron. MDA is an end product of peroxidation of polyunsaturated fatty acids and is a
%U http://www.hindawi.com/journals/isrn.nephrology/2014/634515/