Acute Oxidative Stress following Intravenous Iron Injection in Patients on Chronic Hemodialysis: A Comparison of Iron-Sucrose and Iron-Dextran

BACKGROUND/AIMS: Intravascular iron release from parenteral iron formulations can catalyze various harmful oxidative reactions. These topics have mainly been investigated in vivo with iron-sucrose (IS). The aim of our study was to compare IS and iron-dextran (ID) regarding iron release and induction of oxidative stress. METHODS: Twenty hemodialysis patients were enrolled. Plasma iron and oxidative stress parameters were measured before and 10 min after intravenous (IV) injection of 100 mg IS and ID, respectively. RESULTS: Intravascular iron increased significantly more after IS. The mean ± SD changes in plasma iron were 314 ± 172% after IS versus 90 ± 44% after ID (p < 0.001). Comparable changes in non-transferrin bound iron were 86 ± 42 versus 45 ± 45%, respectively (p < 0.05). Plasma ascorbic free radical did not change following ID (-1.8 ± 11.2%) but increased by 29 ± 31.3% after IS (p < 0.01). Further, protein carbonyls increased following IS (p < 0.05) but not after ID. CONCLUSION: Increased oxidative stress was found only after IV injection with IS.