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.