地拉羅司螯合铁对血液透析患者端粒长度和氧化应激的影响：随机研究

IF 2 4区医学 Q2 UROLOGY & NEPHROLOGY

Nefrologia Pub Date : 2025-01-01 DOI:10.1016/j.nefro.2024.06.006

Blanca Olivia Murillo Ortiz , Joel Ramírez Emiliano , Marcos Javier Romero Vázquez , Lauro Fabián Amador Medina , Sandra Martínez Garza , Edna Montserrat Ramos Rodríguez

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引用次数: 0

摘要

背景：最近的研究已经证明了去铁铁在腹膜透析患者中的有效性、安全性和耐受性，然而，其在血液透析患者中的作用尚未研究。目的探讨铁螯合对血液透析患者端粒长度、氧化应激和铁蛋白水平的影响。方法：这是一项开放标签研究，对照组患者接受血液透析，接受去铁铁素15mg /kg/天的治疗，为期6个月。实时荧光定量PCR测定端粒长度。测定血清铁蛋白水平和氧化指标。采用高效液相色谱法分析血药浓度，评价去铁铁铁的药动学及安全性。结果54例患者接受去铁铁治疗，对照组50例。两组血清铁蛋白水平差异有统计学意义(p <；0.0001)， TBARS（硫代巴比妥酸反应物质）(p <；0.01)。螯合后端粒长度显著增加(p <；0.001)。48 h零时血清去铁素浓度维持在2.67 ~ 23.78 mmol/L范围内。结论血透患者铁螯合可显著降低铁蛋白和TBARS，导致端粒长度增加。去铁铁铁被证明对接受血液透析的铁超载患者有益。

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Impact of iron chelation with deferasirox on telomere length and oxidative stress in hemodialysis patients: A randomized study

Background

Recent studies have demonstrated the effectiveness, safety, and tolerability of deferasirox in patients in peritoneal dialysis, however, its effect has not been studied in patients undergoing hemodialysis.

Objective

To investigate the impact of iron chelation on telomere length, oxidative stress, and ferritin levels in patients undergoing hemodialysis.

Methods

This is an open-label study, with a control group of patients undergoing hemodialysis, who will receive treatment with deferasirox 15 mg/kg/day for 6 months for iron chelation. Telomere length was measured using real-time PCR. Serum ferritin levels and oxidation markers were evaluated. To evaluate the pharmacokinetics and safety of deferasirox, plasma concentrations were analyzed by HPLC.

Results

Fifty-four patients were included to receive deferasirox, and a control group of 50 patients. Significant differences were observed in serum ferritin levels (p < 0.0001), TBARS (thiobarbituric acid reactive substances) (p < 0.01). Telomere length had a significant increase after chelation (p < 0.001). The serum deferasirox concentration at zero time at 48 h was maintained within a range of 2.67–23.78 mmol/L.

Conclusions

Our results demonstrate that iron chelation in hemodialysis patients significantly reduces ferritin and TBARS, resulting in an increase in telomere length. Deferasirox proves to be beneficial for patients with iron overload undergoing hemodialysis.

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来源期刊

Nefrologia 医学-泌尿学与肾脏学

CiteScore

3.40

自引率

7.70%

发文量

148

审稿时长

47 days

期刊介绍： Nefrología is the official publication of the Spanish Society of Nephrology. The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants. It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages.