RESUMO
Renal anemia is one of the most frequently observed complications in patients undergoing chronic hemodialysis [HD]. Reduced red blood cell survival due to oxidative damage is one of causes of anemia in these patients. Vitamin E [alpha - tocopherol] is a natural biological antioxidant, which protects red cells from these effects of reactive oxygen metabolites and could be useful as a collateral therapy for anemia in HD patients. The aim of the present study was to investigate the potential beneficial effect of anti oxidant vitamin E supplementation [oral] on renal anemia and to find out whether this improvement mechanism is attributable to the enhanced hematopoietic function or to prolonged RBC life. This clinical trial study included [8 cases with mean age 14 +/- 2.9 years and 7 controls with mean age 14 +/- 2.7 years] stable children on chronic hemodialysis, at hemodialysis center in Sheikh Children Hospital - Mashhad. At the time of entry, there was no evidence of iron deficiency or history of blood transfusion. All of children [case and control] received subcutaneous erythropoietin [EPO] 120 +/- 80 u/kg/BW/week, Folic acid 1 mg/day and Iron 1-2 mg/kg/day. Oral vitamin E 200 u/day for 3 months was prescribed to cases only. Laboratory parameters determined at the beginning of the study were: Iron, Ferritin, Transferrin, Total Iron binding capacity, Hemoglobin [Hb], Hematocrit, Reticulocyte count and peripheral blood smear. Hb and HCT were checked every month during the study and the results were compared to those obtained earlier. Prescription of oral vitamin E for 3 months resulted in significantly higher levels of Hb and Hct in cases compared to those in controls [11.4 +/- 1.7 vs. 10.1 +/- 1.9 Hb and 35.3 +/- 5 vs. 31.3 +/- 6 Htc, P< 0.05]. Antioxidant vitamin E supplementation improves renal anemia by decrease of oxidative stress and RBC life span in hemodialysis patients