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| Nephrol Dial Transplant. 2004 Aug 3 [Epub ahead of print] Related Articles,
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Oxidative stress induced by iron released from transferrin in low pH peritoneal
dialysis solution.
Yamaji Y, Nakazato Y, Oshima N, Hayashi M, Saruta T.
Kidney Disease Center and Internal Medicine, Saitama Social Insurance Hospital,
Saitama-City, Saitama, Japan.
BACKGROUND: Transferrin binds extracellular iron and protects tissues from
iron-induced oxidative stress. The binding of iron and transferrin is pH
dependent and conventional peritoneal dialysis (PD) solutions have
unphysiologically low pH values. Herein, we investigated whether conventional
PD solution releases iron from transferrin and if the released iron causes
oxidative stress. METHODS: Effects of PD solutions on iron binding to
transferrin were examined with purified human transferrin and transferrin in
dialysates drained from PD patients. Oxidative stress induced by iron released
from transferrin was evaluated in terms of the formation of thiobarbituric acid
reactive substance (TBARS) and protein carbonylation in the human red blood
cell (RBC) membrane. The iron deposition in peritoneal tissue from PD patients
was evaluated by Perls' staining with diaminobenzidine intensification.
RESULTS: Low pH PD solution released iron from transferrin. This iron release
occurred within 1 min. Iron release was not observed in neutralized PD
solution. Iron released from transferrin in low pH PD solution increased TBARS
formation and protein carbonylation in the human RBC membrane. Iron deposition,
which is prominent in the fibrotic area facing the peritoneal cavity, was
observed in the peritoneum of PD patients. CONCLUSIONS: Iron released from
transferrin in low pH PD solution can produce oxidative stress in the
peritoneum of a PD patient. Neutralizing PD solution can avoid this problem.
Iron deposition in the peritoneum may participate in the pathogenesis of
peritoneal fibrosis in PD patients.
PMID: 15292463 [PubMed - as supplied by publisher]
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