Effect of levocarnitine/iron saccharate combination on renal anaemia and oxidative stress in patients undergoing haemodialysis

Hong-Xia Cui,En-Liang Wu

doi:10.4314/tjpr.v15i10.28

Abstract

Purpose: To investigate the effect of a combination of levocarnitine and iron saccharate on the treatment of renal anaemia and oxidative stress in patients undergoing haemodialysis. Methods: A total of 156 patients with renal anaemia were divided randomly into control (78 cases) and test groups (78 cases). Patients in the control group were treated with erythropoietin (EPO), iron saccharate, and conventional symptomatic treatment, while patients in the test group were treated with levocarnitine additionally. Anaemia indices, oxidative stress indices, response rate, and EPO dose were compared. Results: At week 28, the levels of hemoglobin b (Hb), hematocrit (Hct), serum ferritin (SF), and transferrin saturation (TSAT) in the test group were 92.72 ± 12.51 g/L, 34.74 ± 5.89 vol %, 245.61 ± 81.35 ng/mL, and 24.34 ± 5.32 %, respectively, which were much lower than the levels in the test group (114.36 ± 12.27 g/L, 40.23 ± 5.78 vol %, 345.07 ± 85.93 ng/mL, and 29.76 ± 5.41 %, respectively; p < 0.05). The levels of advanced oxidation protein products (AOPP) and malonaldehyde (MDA) in the test group were much higher than those of the control group (121.77 ± 31.65 nmol/L vs 89.65 ± 30.53 nmol/L; 9.58 ± 2.64 nmol/L vs 4.81 ± 2.57 nmol/L, respectively (p < 0.05). EPO was maintained at a high dose from the beginning of treatment to week 28 in the control group, whereas in the test group, EPO dose was reduced gradually. The response rate in the test group was higher than that in the control group (92.30 % vs 76.90 %; p < 0.05). Conclusion: Levocarnitine/iron saccharate combination had a significant positive effect on the treatment of renal anaemia. It effectively relieved oxidative stress reactions and reduced the dose of EPO required. Keywords: Haemodialysis, Renal anaemia, Oxidative stress reaction, Levocarnitine, Iron saccharate, Erythropoietin

Highlights

Renal anaemia, a commonly observed complication in patients with chronic renal failure during the terminal stage, occurs when the glomerular filtration rate (GFR) is reduced by over 50 % [1,2]
This study evaluate the curative effect of iron saccharate combined with levocarnitine in renal anaemia and oxidative stress
Throughout the treatment period, the required EPO dose in the control group remained relatively high, whereas the EPO dose in the test group was reduced gradually

Summary

Introduction

A commonly observed complication in patients with chronic renal failure during the terminal stage, occurs when the glomerular filtration rate (GFR) is reduced by over 50 % [1,2]. Renal anaemia can induce abnormalities in multiple physiological functions, as well as cardiovascular and cerebrovascular diseases, thereby influencing the quality of life of patients with chronic kidney disease and lowering survival rates. Erythropoietin (EPO) can relieve anaemic symptom in patients with chronic renal failure [3]. Some patients with renal anaemia who undergo haemodialysis treatment respond poorly or not at all to EPO because of iron deficiency, chronic infection, and malnutrition [4,5]. Researchers [6,7] have found that iron saccharate can induce an increase in oxidative stress reactions and the occurrence of cardiovascular and cerebrovascular events. Antioxidant interventions are important in patients undergoing haemodialysis

Methods

Results

Conclusion