Investigation of Lipid Peroxidation Products and Antioxidant Enzyme Activities in End-Stage Renal Disease Patients

Background: Intravenous application of iron preparations which is a routine treatment of anemia in hemodialysis patients with end-stage renal disease can lead to iron overload in the body. Redox-active iron can catalyze the formation of hydroxyl radicals and initiation of lipid peroxidation, increase oxidative stress and speed up the development of complications in these patients. Objective: In this study, we determined the markers of lipid peroxidation, protein oxidation and antioxidant enzyme activities (superoxide dismutase, glutathione peroxidase, glutathione S-transferase) in serum of patients with end-stage renal disease on hemodialysis, who had received repeated treatment of iron supplementation. Patients and Methods: The study included 29 patients undergoing regular hemodialysis treatment. These patients were divided into three groups according to the serum ferritin levels: group I (serum ferritin between 100 and 300 mg/L); group II (serum ferritin between 301 and 600 mg/L), and group III (serum ferritin above 601 mg/L). Results: The serum of patients with the highest concentration of serum ferritin and iron contained significantly higher level of lipid peroxidation products, total hydroperoxides and malondialdehyde and advanced oxidation protein products and the lowest concentration of sulfhydryl groups, reduced glutathione and total antioxidant capacity. Conclusion: Based on the obtained results, it can be concluded that iron supplementation in hemodialysis patients and consequently body iron overload of exacerbated oxidative stress have already been present in these patients.