Lipid peroxidation products formation with various intravenous iron preparations in chronic kidney disease

The role of intravenous iron in contributing to oxidative stress and endothelial dysfunction in chronic kidney disease (CKD) is debatable. The present study assessed differences in fasting plasma malondialdehyde (pMDA) levels 30 minutes before and after intravenous infusion of low molecular weight iron dextran (ID) (n = 19), iron-sucrose (IS) (n = 20), and sodium ferrigluconate complex (SFGC) (n = 20) in stage 3 and 4 CKD patients. Post-infusion pMDA levels were significantly raised with respect to baseline (p0.001). pMDA was significantly higher in the SFGC group vs. IS (3.02 +/- 0.84 micromol/L vs. 2.82 +/- 0.44 micromol/L, p = 0.034) or SFGC vs. ID (3.02 +/- 0.84 micromol/L vs. 2.92 +/- 0.20 micromol/L, p = 0.048). There was no difference between IS vs. ID (2.82 +/- 0.44 micromol/L vs. 2.92 +/- 0.20 micromol/L, p = 0.21). To conclude, all forms of parenteral iron, especially SFGC, significantly raise pMDA levels in the immediate post-transfusion period.