Journal Article

Intravenous iron-gluconate during haemodialysis modifies plasma β<sub>2</sub>-microglobulin properties and levels

Regina Michelis, Shifra Sela and Batya Kristal

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 20, issue 9, pages 1963-1969
Published in print September 2005 | ISSN: 0931-0509
Published online June 2005 | e-ISSN: 1460-2385 | DOI:
Intravenous iron-gluconate during haemodialysis modifies plasma β2-microglobulin properties and levels

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Background. Intravenous iron replacement therapy is routinely used for correction of anaemia in patients with end-stage renal failure. Free or labile iron, present both in parenteral iron formulations and in blood of haemodialysis (HD) patients, has the potential to induce severe oxidative processes. This study evaluated the acute in vivo effect of intravenous iron administration on the oxidation of plasma β2-microglobulin (β2m) and on its plasma levels after HD.

Methods. Iron-gluconate was administered intravenously to 14 patients receiving HD with low-flux cellulose-triacetate membranes during the first hour of the 4 h HD treatment. Each patient underwent three different dialysis treatments, during which an infusion of 62.5, 125 or 0 mg (control) of iron-gluconate was administered in random order. Plasma β2m levels and iron parameters were monitored immediately before and after each HD treatment. The molecular isoforms of β2m were studied by two-dimensional gel electrophoresis and western analysis. Levels of oxidized β2m were evaluated by reaction with 2,4-dinitrophenylhydrazine and western analysis.

Results. Both doses of iron-gluconate caused remarkable changes in the molecular properties of β2m, including shift in isoelectric point, molecular mass and degree of oxidation. Iron administration also limited the decline in plasma β2m levels to <7.5%, compared with 27.9±2.7% during HD without iron.

Conclusions. Intravenous iron-gluconate led to a characteristic increase in molecular weight and in negative charge of β2m, both of which can be assumed to be consistent with reduced membrane sieving coefficients and membrane adsorption, and thus with reduced clearance of β2m.

Keywords: advanced glycation end-products; carbonyl; iron-gluconate; low flux; protein oxidation

Journal Article.  4167 words.  Illustrated.

Subjects: Nephrology

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