Comparative Study of Oxidative Stress Markers in Hemodialysis (HD) versus Peritoneal Dialysis (PD) Patients

Abstract

Introduction: Chronic kidney disease (CKD) patients on dialysis frequently develop anemia due to iron deficiency, blood loss, and chronic inflammation. Hemodialysis (HD) often involves intravenous iron therapy, which can elevate ferritin, while peritoneal dialysis (PD) patients may experience iron depletion through peritoneal losses. Ferritin, transferrin saturation (TSAT), and total iron binding capacity (TIBC) are key markers of iron status, but their interpretation is complicated by inflammation. Interleukin 6 (IL 6), a pro inflammatory cytokine, further influences iron metabolism and anemia. Comparing these parameters in HD and PD patients is essential for tailoring iron management strategies.

Aim: To compare iron and inflammatory markers between hemodialysis (HD) and peritoneal dialysis (PD) patients, and assess correlations with age and gender.

Methods: A cross sectional study of 70 ESRD patients (35 HD, 35 PD) was conducted. Serum iron, total iron binding capacity (TIBC), transferrin saturation (TSAT), ferritin, and interleukin 6 (IL 6) were measured using standard biochemical and ELISA methods. Statistical comparisons were made using Student’s t test, and correlations were assessed with Pearson’s coefficient.

Results: IL 6, serum iron, and TIBC did not differ significantly between HD and PD (p> 0.05). Serum ferritin was significantly higher in HD (574.05 ± 341.04 ng/ml) compared to PD (370.91 ± 292.38 ng/ml, p = 0.009). Age showed a weak negative correlation with ferritin, while females had higher ferritin than males.

Conclusion: HD patients exhibit elevated ferritin levels, likely reflecting iron supplementation and inflammation. Ferritin should be interpreted cautiously, and iron management strategies tailored to dialysis modality, age, and gender.