PERSONAL DE APOYO
CAO Gabriel Fernando
artículos
Título:
COMPARISON OF THE RENAL, CARDIOVASCULAR AND HEPATIC TOXICITY DATA OF ORIGINAL INTRAVENOUS IRON COMPOUNDS
Autor/es:
TOBLLI JE, CAO G, OLIVIERI L, ANGEROSA M
Revista:
NEPHROL DIAL TRANSPLANT
Editorial:
Oxford : Oxford University Press
Referencias:
Año: 2010 p. 3631 - 3640
ISSN:
1753-0784
Resumen:
Background. Intravenous (i.v.) iron is essential for managing
haemoglobin levels in haemodialysis patients. However,
i.v. iron may cause variable degrees of toxicity. This is
mainly related to the pharmacological characteristics of
any given i.v. iron compound.
Methods. This blinded study examines the effects of five
i.v. iron preparations on haemodynamic and functional parameters.
Sixty Sprague-Dawley rats (n=10/group) received
high or low molecular weight (HMW/LMW) iron dextran,
ferric gluconate (FG), ferric carboxymaltose (FCM), iron
sucrose (ISC) or isotonic saline solution (control). Five
i.v. doses of iron (40 mg iron/kg) or saline were administered
over 4 weeks.
Results. Systolic blood pressure was significantly reduced
in the LMW dextran group, whereas serum iron
and percentage transferrin saturation were significantly
elevated in all treatment groups. Creatinine clearance
was reduced and urinary protein excretion increased in
the FG group only (P < 0.01). Liver enzyme levels in
the blood were increased (P < 0.01) in the FG and two
dextran groups compared with the FCM and ISC
groups. Analysis of liver, heart and kidney homogenates
showed a significant increase in catalase and malondialdehyde
levels in the FG group, and an increase in
CuZn-superoxide dismutase and glutathione (GSH) peroxidase
activity accompanied with a decrease in the reduced-
to-oxidized GSH ratio in the FG and two dextran
groups (P < 0.01). Tumour necrosis factor alpha and interleukin-
6 levels were significantly elevated in liver,
heart and kidney samples from the FG and two dextran
groups but not the FCM, ISC or control groups.
Conclusions. These findings indicate that FG and HMW/
LMW iron dextran have less favourable safety profiles
than FCM and ISC in normal rats.