Effects Of Vitamin E On Oxidative Stress And Disturbance Of Lipid Metabolism Induced By Intravenous Iron Infusion In Maintenance Hemodialysis Patients

Backgrounds and purposes: Iron deficient exists generally in chronic renal disease especially in MHD. In EPO treated hemodialysis patients forum store had not been keeped with oral iron , And intravenous iron infusion is a effective therapy. But intravenous iron infusion may intensify underlaying oxidative stress . OS lies in Lipid Peroxidation, enhance disturbance of lipid metabolism, became a important impactor of atherogenesis. And now how to anesis OS and disturbance of lipid metabolism in intravenous iron infusion attract our attention. Our experiment is to examine the effects of vitamin E as an antioxidant on oxidative stress and disturbance of lipid metabolism induced by intravenous iron sucrose infusion in treatment of anemia of MHD patient.Methods: 40MHD patients were selected and randomly divided into intravenous iron group(n=20) and intravenous iron+vitamin E group(n=20) compared with 20 healthy people. Intravenous iron group: 100mg iron sucrose rejections that was dissolved in 100ml of 0.9% Nacl solution were used while the patients accepted hemodialysis. At the beginning patients received iron two or three times every week until complete the total dose of 1000mg, later the patients reeived iron treatment every one or two weeks made the serum ferritin maintained at between 100ug/L to 300ug/L.Intravenous iron+vitamin E group : same with the first group and add oral vitE200mg, two times one day, Erythropoietin(EPO) was used at a dose of 100^-150U/kg-w by hypodermic in each group. TG.TCH.LDL.VLDL.HDL.LpAApoB.SOD .MDA.AOPP.GSH-Px were test in each group at the beginning and with treatment of 1 and 6 months later.Results: at the beginning of treatment, Serum level of SOD and GSH-px decreased (p<0.05) and MDA,AOPP increased, Serum level of TG,LDL,VLDL,LpA,ApoB was higher compare with healthy group, HDL,ApoA1 decreased (p<0.05). But no significant changes in TCH.Iron treatment for 1 month MDA,AOPP,TCH,Lp(a),ApoB increased (p<0.05) but GSH-Px,SOD,ApoA1 activity decreased (p<0.05) than those pretherapy in iron group. No significant changes in TG,LDL,VLDL,HDL.(p>0.05) Vitamin E treatment for 1 month serum SOD,GSH-Px of intravenous iron+vitamin E group increased slightly compared with iron group (p>0.05), AOPP,MDA activity were slightly lower than that in controls. But there were no significant difference both. TG,LDL,HDL,VLDL ApoA1,ApoB,Lp(a) have no significant changes also.(p>0.05). But TCH decreased obviously(p<0.05) .Vitamin E treatment for 6 month serum SOD,GSH-Px and b ApoAlecome higher significantly, AOPP,MDA TCH,Lp(a),and ApoB activity were obviously lower (p<0.05) compare with iron group. No significant changes in TG,LDL,HDL,VLDL(p>0.05)Conclusion: MHD patients with higher levels of oxidatives and Lipid metabolism disorders Compared with the normal. Intravenous iron can aggravate the situation. There are no significant relationship between treatment time and intensity with the levels of oxidatives induced by Intravenous iron Oral of 200mg vitamin E for long term can attenuate oxidative stress and lipid metabolism disorders induced by Intravenous iron.