, Volume 21, Issue 2, pp 159–170 | Cite as

Iron-induced oxidative stress in haemodialysis patients: a pilot study on the impact of diabetes

  • Ann Van Campenhout
  • Christel Van Campenhout
  • Albert Lagrou
  • Begoña Manuel-y-Keenoy


Background: Administration of intravenous iron preparations in haemodialysis patients may lead to the appearance of non-transferrin bound iron which can catalyse oxidative damage. We investigated this hypothesis by monitoring the oxidative stress of haemodialysis patients and the impact of iron and diabetes mellitus herein. Materials and methods: Baseline values of serum iron and related proteins, transferrin glycation, non-transferrin bound iron, antioxidant capacity and lipid peroxidation (malondialdehyde) of 11 haemodialysis patients (six non-diabetic and five type 2 diabetes) were compared to those of non-haemodialysis control subjects (non-diabetic and type 2 diabetes). Changes in these parameters were monitored during haemodialysis before and after iron administration. Results: Baseline values of malondialdehyde correlated with ferritin concentration (r = 0.664, P = 0.036) and were elevated to the same extent in non-diabetic and diabetic haemodialysis patients (median of 1.09 compared to 0.60 μmol/l in control persons, P < 0.02). After iron infusion, transferrin saturation increased more markedly in non-diabetic subjects from 28% to 185% vs. from 33% to 101% in diabetic patients (P = 0.008). This increase was accompanied by the appearance of non-transferrin bound iron (5.91 ± 1.33 μmol/l), a loss in plasma iron-binding antioxidant capacity and a further increase in malondialdehyde which was more pronounced in diabetic patients (from 0.93 ± 0.30 μmol/l to 2.21 ± 0.69 μmol/l vs. from 1.21 ± 0.42 μmol/l to 1.86 ± 0.56 μmol/l in the non-diabetic subjects, P = 0.046). Conclusions: In haemodialysis patients, higher lipid peroxidation is determined by higher body iron stores. The increase induced by iron infusion is accompanied by a loss in iron-binding antioxidant capacity and is more pronounced in diabetes mellitus.


Haemodialysis Iron Oxidative stress Diabetes 



Analysis of variance


Coefficient of variation




Non-transferrin bound iron


Total antioxidant capacity-percent inhibition and -Trolox equivalents


Total iron-binding capacity





We thank P. Aerts, K. Demol, M. Vinckx and J. Vertommen of the Laboratory of Endocrinology for their technical support. For the recruitment of the study subjects, we gratefully acknowledge the nurses from the department of Nephrology, Prof. Dr. G. Moorkens from the department of Internal Medicine and Prof. Dr. L. Van Gaal from the department of Diabetology, Nutrition Pathology and Metabolic Disorders of the University Hospital of Antwerp. A.V.C. was financially supported by the ‘Institute for the Promotion of Innovation through Science and Technology in Flanders (IWT-Vlaanderen)’.


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Copyright information

© Springer Science+Business Media BV 2007

Authors and Affiliations

  • Ann Van Campenhout
    • 1
  • Christel Van Campenhout
    • 2
  • Albert Lagrou
    • 3
  • Begoña Manuel-y-Keenoy
    • 4
  1. 1.Vascular Biology UnitJames Cook UniversityTownsvilleAustralia
  2. 2.Clinical BiologyFederal Scientific Institute of Public HealthBrusselsBelgium
  3. 3.Laboratory of Human BiochemistryUniversity of AntwerpAntwerpBelgium
  4. 4.Metabolic Research UnitUniversity of AntwerpWilrijk-AntwerpBelgium

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