Intravenous Iron Gluconate Administration Increases Circulating PAPP-A in Hemodialysis Patients |
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Authors: | Magdalena Hodkova Marta Kalousova Sylvie Dusilova-Sulkova Ivan Matous Malbohan Tomas Zima |
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Affiliation: | 1. Institute of Medical Biochemistry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic;2. Department of Medicine Strahov, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republicmagdalena.hodkova@seznam.cz;4. Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic;5. Department of Medicine Strahov, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic;6. Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic |
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Abstract: | Background. Pregnancy-associated plasma protein-A (PAPP-A) is a proatherosclerotic molecule, interrelated with oxidative stress in hemodialysis (HD) patients. As intravenous (IV) iron might enhance oxidative stress in HD patients, this study investigates circulating PAPP-A during HD session and after IV iron administration. Methods. In 20 HD patients, plasma PAPP-A concentration was assessed immunochemically during 2 HD sessions (prior to HD and at 60, 130, and 240 min of HD session). Sodium ferric gluconate (62.5 mg) was given IV to all patients 65 min after the start of the second HD. Results. Sixty-five min after IV iron application, there was a significant increase in plasma PAPP-A (from 36.0 ± 9.9 to 79.6 ± 28.9 mU/L, p < 0.0001). At the end of this HD session, PAPP-A decreased significantly (p < 0.0001), but still remained 1.5-fold greater compared with predialysis levels (p < 0.0005). Conclusion. IV iron increases circulating PAPP-A, and in this way, it might contribute to more pronounced cardiovascular complications in HD patients. |
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Keywords: | atherosclerosis hemodialysis intravenous iron oxidative stress pregnancy-associated plasma protein-A (PAPP-A) |
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