Impact of Oxidative Stress in Premature Aging and Iron Overload in Hemodialysis Patients.

Blanca Murillo-Ortiz,Joel Ramírez Emiliano,Sergio Solorio-Meza,Edna Ramos-Rodríguez,Luis Benítez- Bribiesca,Sandra Martínez-Garza,Wendy Ivett Hernández Vázquez,Froylán Albarrán-Tamayo

doi:10.1155/2016/1578235

Abstract

Background. Increased oxidative stress is a well described feature of patients in hemodialysis. Their need for multiple blood transfusions and supplemental iron causes a significant iron overload that has recently been associated with increased oxidation of polyunsaturated lipids and accelerated aging due to DNA damage caused by telomere shortening. Methods. A total of 70 patients were evaluated concomitantly, 35 volunteers with ferritin levels below 500 ng/mL (Group A) and 35 volunteers with ferritin levels higher than 500 ng/mL (Group B). A sample of venous blood was taken to extract DNA from leukocytes and to measure relative telomere length by real-time PCR. Results. Patients in Group B had significantly higher plasma TBARS (p = 0.008), carbonyls (p = 0.0004), and urea (p = 0.02) compared with those in Group A. Telomeres were significantly shorter in Group B, 0.66 (SD, 0.051), compared with 0.75 (SD, 0.155) in Group A (p = 0.0017). We observed a statistically significant association between relative telomere length and ferritin levels (r = −0.37, p = 0.001). Relative telomere length was inversely related to time on hemodialysis (r = −0.27, p = 0.02). Conclusions. Our findings demonstrate that iron overload was associated with increased levels of oxidative stress and shorter relative telomere length.

Highlights

Iron overload is a common complication in patients with renal chronic failure submitted to hemodialysis (HD)
We found through the analysis of echocardiographic parameters that hypertrophy of the left ventricle, related to the Left Ventricular Mass Index (LVMI), was higher in the high ferritin level group (29 patients, 82.86%, versus 8 patients, 22.86%, p = 0.01)
The results of this study suggest that higher ferritin levels are associated with increased telomere shortening in hemodialysis patients

Summary

Introduction

Iron overload is a common complication in patients with renal chronic failure submitted to hemodialysis (HD). It results from the necessity that these patients undergo transfusions of red cells to treat symptomatic anemia, as well as from the administration of enteral and/or parenteral iron supplements [1] It is still controversial, multiple clinical studies have found an association between iron overload and the oxidation of polyunsaturated lipids catalyzed by metallic ions in atherosclerotic disease and in the development of cardiovascular events [2, 3]. Increased oxidative stress is a well described feature of patients in hemodialysis Their need for multiple blood transfusions and supplemental iron causes a significant iron overload that has recently been associated with increased oxidation of polyunsaturated lipids and accelerated aging due to DNA damage caused by telomere shortening. Our findings demonstrate that iron overload was associated with increased levels of oxidative stress and shorter relative telomere length

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Discussion

Conclusion