The Effect Of Different Schedule For Intravenous Iron Administration On Anemia And Oxidative Stress Response In Maintenance Hemodialysis Patients

Backgroud:Renal anemia is major complications of chronic renal failure, especially in maintenance hemodialysis patients and can a series of physiological function abnormal, directly influences the quality of life and dialytic patient surial. The use of Erythropoietin (EPO) and intravenous iron improved anemia in patients, but a large number of experiments confirm that intravenous iron can induce oxidative stress in MHD. Oxidative stress is likely to cause the cardiovascular of hemodialysis patients, and cardiovascular complications is the main cause of death in MHD. Currently existing in iron oxidatie stress caused by intravenous iron used some antioxidation drugs and special dialysis membranes, but certainly increased economic burden of the patient. We will study the different schedule for intravenous iron, in order to reduce oxidative stress by adjusting the schedule for intravenous iron in MHD patients.Objective:This study will compare different schedule for intravenous iron supplementation program on the impact of oxidative stress in MHD patients, To find a iron supplement program not only improve anemia in MHD patients,but also induce oxidative stress very small.Methods:Attached to the Second Xiangya Hospital, chose 58 cases of MHD patients were randomly divided into treatment group repeated low-dose iron supplementation group (n=19), intermittent iron supplementation group (n=19) and non-iron group (n=20), a control group (n=20). Repeated low-dose iron supplementation group:25mg iron sucrose rejection that was dissolved in 100ml of o.9% Nacl solution were used after 2h of hemodialysis, maintenance 1h,2 times per week. Intermittent iron supplementation group:100mg iron sucrose rejection that was dissolved in 100ml of o.9% Nacl solution were used after 2h of hemodialysis, maintenance 1h,1 time every 2 weeks. Non iron group: during the experiment,the patients are not offer any form of iron. Three groups are to be EPO treatment (120-180U/Kg·W). A total of 8 weeks. Detection of three groups of patients before treatment and after 8 weeks of the change of hematology and iron. The level of oxidative stress indicators (MDA,MPO,SOD) of the normal control group. The experiment of the first intravenous iron before hemodialysis, after hemodialysis, and the two groups after 8 weeks treatment in patients with oxidative stress parameters (MDA,MPO,SOD), and The level of oxidative stress indicators (MDA,MPO,SOD) of the non-iron group at the same time.Results:Before treatment, compared with the control group, MHD patients MDA, MPO levels were significantly higher value (p<0.01),the serum SOD values decreased (P＜0.01), Test after the first intravenous iron in MHD patients MDA, MPO values higher than before hemodialysis (P<0.01), serum SOD values lower than before hemodialysis (P＜0.01), repeated low-dose iron supplementation group and intermittent iron supplementation group the value of MDA, MPO compare with non iron supplementation group increased more significantly, the difference statistically significant (P<0.01), serum SOD values decreased significantly, with a statistically significant difference (P<0.01). Repeated low-dose iron supplementation group compared with intermittent iron supplementation, MDA, MPO is lower than intermittent iron supplementation group (P＜0.01), SOD was higher than intermittent iron supplementation group (P＜0.01). After 8 weeks, repeated low-dose iron supplementation group and intermittent iron supplementation group MDA, MPO, SOD was no significant difference (P>0.05). Hematology and iron indices in repeated low-dose iron supplementation group and intermittent iron supplementation group significantly higher than that before treatment (P＜0.01), compared between the two groups, the difference was not statistically significant (P>0.05), compared with no iron supplementation significantly increased, there was significant difference (P＜0.01).Conclusion:Oxidative stress inherent in MHD patients, hemodialysis and intravenous iron can increase oxidative stress in patients. Repeated low-dose iron supplementation and intermittent iron supplementation can improve anemia in MHD patients, and have the same effect. The acute oxidative stress induced by repeated low-dose iron supplementation group was lower than intermittent iron supplementation, but have the same long-term impact.