Intravenous Iron Sucrose in Peritoneal Dialysis Patients with Renal Anemia

2008 ◽  
Vol 28 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Han Li ◽  
Shi-Xiang Wang
Keyword(s):  
Peritoneal Dialysis ◽  
Hematological Parameters ◽  
Medical Science ◽  
Transferrin Saturation ◽  
Intravenous Iron ◽  
Iron Sucrose ◽  
Dose Frequency ◽  
Parallel Group ◽  
Oral Group ◽  
Iv Iron

Objective To explore the safety and efficacy of intravenous (IV) iron sucrose in maintenance peritoneal dialysis (PD). Design Randomized, controlled, parallel-group single-center trial. Setting Blood Purification Center of Chaoyang, Beijing Capital University of Medical Science, China. Methods 46 patients on PD were involved in this trial. 26 patients received IV iron sucrose (200 mg iron) once per week for 4 weeks then once every other week for a further 4 weeks. The other 20 patients received oral ferrous succinate, 200 mg three times per day, for 8 weeks. Hemoglobin, hematocrit, serum ferritin (SF) level, and transferrin saturation (TSAT) were assessed at baseline and then again after 2, 4, and 8 weeks of treatment. Results There were no differences between the IV and oral groups in terms of sex, age, duration of PD, mean dialysate dosage per day, erythropoietin dosage per week, or hematological parameters at baseline. After 4 and 8 weeks of treatment, mean Hb and Hct were significantly increased in the IV group and were also significantly higher than those in the oral group. Levels of SF and TSAT were also significantly increased in the IV group, and significantly higher than in the oral group. After 8 weeks, the response rate in the IV group was 94.8%, which was significantly higher than that in the oral group. The mean erythropoietin dose was significantly lower in the IV group than in the oral group. Hb, Hct, SF, and TSAT levels were maintained between 4 and 8 weeks in the IV group despite the decrease in dose frequency. There were no adverse events with IV iron. Eight patients in the oral group had adverse gastrointestinal effects. Conclusion IV iron sucrose is safe in PD patients. It increases Hb levels and serum iron parameters more effectively than oral iron; it is well tolerated and can permit reductions in the required dose of erythropoietin.

scholarly journals Intravenous infusion of total dose iron is superior to oral iron in treatment of anemia in peritoneal dialysis patients: a single center comparative study.

1998 ◽  
Vol 9 (4) ◽  
pp. 664-668 ◽  
Author(s):  
N Ahsan
Keyword(s):  
Peritoneal Dialysis ◽  
Total Dose ◽  
Intravenous Infusion ◽  
Iron Supplementation ◽  
Transferrin Saturation ◽  
Intravenous Iron ◽  
Outpatient Setting ◽  
Oral Iron ◽  
Human Erythropoietin ◽  
Oral Group

In the treatment of anemia of chronic renal failure, the most common cause of recombinant human erythropoietin (rhEPO) resistance is iron deficiency. In peritoneal dialysis (PD) patients, oral iron therapy is an accepted and convenient method of iron supplementation. The effectiveness of oral iron, however, is limited by many factors, including gastrointestinal side effects and poor gastric absorption. This study prospectively compared the efficacy of single intravenous infusion of total dose iron (ITDI group) given in an outpatient setting with oral iron (oral group) for the treatment of anemia in PD patients. Twenty-five adult stable PD patients with baseline hematocrit 25 to 35% were entered into the study. Thirteen patients with serum transferrin saturation (TSAT) < 25% received ITDI, and 12 patients with TSAT between 25 and 35% received oral iron. One patient in the oral group received emergent blood transfusion and was excluded from analysis. Hematocrit and iron indices were measured at monthly intervals. Doses of rhEPO were adjusted monthly to maintain target hematocrit at 35%. At the end of the study (6 mo), despite similar baseline mean hematocrit (31.0 +/- 0.9 versus 33.0 +/- 1.0%), comparable mean baseline weekly rhEPO dose (7886 +/- 1449 versus 6370 +/- 1553 U/wk), and significantly lower level of mean TSAT (11.3 +/- 3.5 versus 30.1 +/- 3.5%; P < 0.05), the ITDI group when compared with the oral group had significantly higher mean hematocrit (36.0 +/- 1.0 versus 31.4 +/- 1.1%; P < 0.05) and TSAT (33.7 +/- 3.7 versus 22.6 +/- 4.0%; P < 0.05) values. In addition, the final mean dose of weekly rhEPO was significantly lower in the ITDI group (4799 +/- 981 versus 9998 +/- 1027 U/wk; P < 0.05). No patient in the ITDI group developed an adverse reaction to intravenous iron. It is concluded that ITDI represents a more efficacious method of iron supplementation in PD patients receiving rhEPO. Moreover, ITDI is safe and well tolerated and can be administered in an outpatient setting.

Efficacy of a Low-Dose Intravenous Iron Sucrose Regimen in Peritoneal Dialysis Patients

2002 ◽  
Vol 22 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Elisabeth Dittrich ◽  
Martin Schillinger ◽  
Gere Sunder–Plassmann ◽  
Walter H. Hörl ◽  
Andreas Vychytil
Keyword(s):  
Peritoneal Dialysis ◽  
Iron Deficiency ◽  
Serum Ferritin ◽  
Low Dose ◽  
Transferrin Saturation ◽  
Iron Sucrose ◽  
Dialysis Patients ◽  
Functional Iron Deficiency ◽  
Iv Iron ◽  
Absolute Iron Deficiency

Objective Sufficient iron substitution leads to a decrease in the required recombinant human erythropoietin (rHuEPO) dose and/or an increased hematocrit in dialysis patients. Intravenous (IV) application of larger doses of iron sucrose may be associated with hyperferritinemia, appearance of catalytically free iron, and impaired phagocyte function. Therefore, we investigated the effectiveness of a low-dose IV iron regimen in peritoneal dialysis (PD) patients. Patients and Interventions Forty-five PD patients were followed over a period of 1 year. Serum ferritin, serum transferrin saturation, and hemoglobin were measured monthly. In cases of absolute iron deficiency (serum ferritin < 100 μg/L), 50 mg iron sucrose was given IV every second week. In cases of functional iron deficiency (ferritin ≥ 100 μg/L and transferrin saturation < 20%) and in iron repleted patients (ferritin ≥ 100 μg/L and transferrin saturation ≥ 20%), 50 mg IV iron sucrose was applied monthly. Iron therapy was stopped in cases of acute infection (until complete recovery) and when serum ferritin level was ≥ 600 μg/L. Results To analyze the influence of iron substitution on erythropoiesis and rHuEPO requirements, the EPO resistance index (ERI; quotient of rHuEPO dose in units/kilogram/week and hemoglobin in grams per deciliter) was calculated every 3 months. The ERI decreased significantly during the course of the study in the whole patient group ( p = 0.009) as well as in the subgroup of 21 patients with absolute iron deficiency ( p = 0.01). A nonsignificant decrease in the ERI was observed within the group of 14 iron repleted patients ( p = 0.5). There was no significant change in the ERI in 10 patients with functional iron deficiency ( p = 0.6). Conclusion The low-dose IV iron regimen used in this study substantially decreased rHuEPO requirements in patients with absolute iron deficiency and was effective in maintaining iron stores in iron repleted patients. However, in the absence of significant hyperparathyroidism, aluminum toxicity, or inadequate dialysis, it did not improve the ERI in patients with functional iron deficiency.

Retrospective analysis of intravenous iron-sucrose therapy in patients undergoing chemotherapy at a tertiary-care center in India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e13068-e13068
Author(s):  
Jyoti Bajpai ◽  
Sudeep Gupta ◽  
Kajal Shah ◽  
Jaya Ghosh ◽  
Vanita Noronha ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Cancer Patients ◽  
Tertiary Care ◽  
Transferrin Saturation ◽  
Intravenous Iron ◽  
Iron Sucrose ◽  
Nutritional Deficiencies ◽  
Iron Administration ◽  
Iv Iron ◽  
The Mean

e13068 Background: Cancer patients frequently have anemia as a result of nutritional deficiencies, malignancy or its treatment. Administration of intravenous (IV)-iron is a therapeutic option in cancer patients with iron-deficiency-related-anemia. Methods: This is a single-institution retrospective-study of 399 patients who were undergoing chemotherapy for non-myeloid malignancies from January 2006 to December 2009 and had hemoglobin ≤11 gm/dl. They received two doses of iron-sucrose, 200-300 mg each as short IV- infusion, 3 weeks apart. The data was recorded at baseline and 3-6 weeks after IV-iron administration in all patients. Results: Of 399 patients, 326(81.7%) had non-hematological malignancies. Transferrin-saturation (TSA) was available in 149 patients. The mean (range) baseline hemoglobin, mean-corpuscular-volume (MCV) and TSA were 9.75(8.0-11.3) gm/dl, 82.4(52.5-100.3) fl and 18.38 (5.2-34.0)%, respectively. After 2 doses of IV-iron hemoglobin increased in 340 (85.2%), reduced in 32 (8.0%) and did not change in 27 (6.7%) patients. The mean (range) increase in hemoglobin was 0.7 (-3.2 to +3.2) g/dl in all patients and 0.95 (0.1-3.2) g/dl in 340 patients in whom it increased after IV-iron. The data were analyzed by low (≤ 83 fl) versus normal (>83 fl) MCV and low (≤20%) versus normal (>20%) TSA. Hemoglobin increased more than the mean increment (0.7 g/dl) in 63.8% patients with low MCV compared to 39.2% of patients with normal MCV (p=0.002). Hemoglobin increased more than the mean increment (0.7 g/dl) in 60.4% of patients with low TSA compared to 58.6% with normal TSA (p=0.479). These results suggest that IV iron was more efficacious in patients with low MCV. Two patients (0.005%) developed anaphylactic shock during or shortly after IV-iron administration and 35 (11.7%) had minor side effects. Thirty (7.5%) patients received RBC transfusions during their continued chemotherapy. Conclusions: Intravenous-iron improved hemoglobin during continued chemotherapy in the large majority of cancer patients with anemia and was safe and tolerable. Low MCV might serve as a surrogate for iron-deficiency-microcytic-anemia in developing-world.

scholarly journals What do we learn about the “Anemia Module” of the French language Peritoneal Dialysis ? Interest and Results

2019 ◽  
Vol 2 (3) ◽  
pp. 143-149
Author(s):  
Belkacem Issad ◽  
Mireille Griuncelli ◽  
Christian Verger ◽  
Guy Rostoker
Keyword(s):  
Peritoneal Dialysis ◽  
Transferrin Saturation ◽  
Intravenous Iron ◽  
Therapeutic Benefit ◽  
French Language ◽  
Biological Assessment ◽  
Erythropoiesis Stimulating Agents ◽  
Treatment Practices ◽  
Target Values ◽  
Dialysis Vintage

Background: Anemia is commonly observed in patients with chronic kidney disease (CKD) as soon as the glomerular filtration rate falls below than 30 ml/min. CKD patients frequently have iron deficiency. The use of both erythropoiesis-stimulating agents (ESA) and iron therapy is the backbone of anemia management in CKD. For this reason, an adequate iron supply is mandatory to achieve the optimal therapeutic benefit of erythropoiesis stimulating agents (ESAs). Many groups agree that anemia in peritoneal dialysis (PD) patients is less severe than in hemodialysis (HD) patients and that there are important differences in treatment practices for anemia between PD and HD patients. Methods: Analysis of the Anemia module of the French Language Peritoneal Dialysis Registry (RDPLF) register from the database set up in 2005 with a study of the period 2010-2017. Results: Data from 568 patients who participated in the Anemia module were analysed during the 2010-2017 follow-up period. Their median age were 71 years, 42% were female, median dialysis vintage was 13 months, 40,5% of patients had diabetes mellitus, 74% of patients were treated with ESA, 23% were on oral iron and only 11% have received intravenous iron. In terms of biological assessment, the average hemoglobin level was close to 12 g/dl and median CRP was close to 5 mg/l. For the iron balance, ferritin reached an average level of 270 µg/l in 2013 and stabilized in 2017 at 200 µg/l. The transferrin saturation coefficient always fluctuated between 23 % and 25 % from year 2010 to year 2017. Conclusion: The results of the Anemia module of RDPLF register appear to be in line with the target values of the ERA-EDTA latest European guideline on anemia (ERBP 2013) and show the low use of intravenous iron in PD (usually as second line therapy).

scholarly journals Effectiveness and safety of ferric carboxymaltose therapy in peritoneal dialysis patients: an observational study

2019 ◽  
Author(s):  
Jose Portolés-Pérez ◽  
Beatriz Durá-Gúrpide ◽  
José Luis Merino-Rivas ◽  
Leyre Martín-Rodriguez ◽  
Covadonga Hevia-Ojanguren ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Medical Records ◽  
Transferrin Saturation ◽  
Ferric Carboxymaltose ◽  
Serious Adverse Event ◽  
Population Mean ◽  
Safety Population ◽  
Iv Iron ◽  
Efficacy Population

Abstract Background The efficacy of intravenous (IV) ferric carboxymaltose (FCM) has been demonstrated in haemodialysis and non-dialysis studies, but evidence is lacking in patients undergoing peritoneal dialysis (PD). Methods This multicentre, retrospective study evaluated the effectiveness and safety of FCM in patients on PD over 12 months. We retrospectively reviewed the electronic medical records of PD patients who initiated FCM treatment between 2014 and 2017 across seven Spanish centres. Results Ninety-one patients were included in the safety population (mean ± SD age 57.7 ± 15.0 years) and 70 in the efficacy population (mean age 50.9 ± 14.5 years). No hypersensitivity reaction, FCM discontinuation or dose adjustment due to a serious adverse event (SAE) was registered in the safety population. The most common non-SAEs reported were headache (four events), mild hypotension (three events) and hypertension (two events), among others. In the efficacy population (n = 70), 68.6% of patients achieved ferritin levels of 200–800 ng/mL, 78.4% achieved transferrin saturation (TSAT) >20%, and 62.8% achieved TSAT >20% and ferritin >200 ng/mL after 12 months of FCM initiation (P < 0.01). Haemoglobin (Hb) levels were maintained at >11 g/dL with a lower dose of darbepoetin throughout the follow-up. The sub-analysis of patients naïve to IV iron and with absolute or relative iron deficiency (n = 51) showed that 76.5% reached ferritin >200 ng/mL, 80.4% TSAT >20% and Hb increased (1.2 g/dL) after 4 months of FCM treatment (P < 0.01). Conclusion In this multicentre, retrospective, real-world study conducted in the PD population, FCM was effective, safe and easy to administer during routine clinical visits.

Intravenous Iron Sucrose

2017 ◽  
Vol 1 (1) ◽  
pp. 20-22
Author(s):  
KS Kavitha Gautham
Keyword(s):  
Iron Deficiency ◽  
Health Problem ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Current Understanding ◽  
Iron Therapy ◽  
Iron Supplement ◽  
Iv Iron

ABSTRACT Iron deficiency is a major worldwide health problem. There is recent evidence that anemia is the last manifestation of the syndrome. Advances in outlining the physiology of iron deficiency have been made; gaps remain in the current understanding. While oral iron supplement remains the mainstay, some indications for intravenous (IV) administration have developed. In this review, we will highlight the indications and prerequisites of IV iron therapy, dosage, safety, and method of administration. How to cite this article Gautham KSK. Intravenous Iron Sucrose. World J Anemia 2017;1(1):20-22.

Effect of Intravenous Iron Sucrose on Oxidative Stress in Peritoneal Dialysis Patients

Renal Failure ◽  
2007 ◽  
Vol 29 (7) ◽  
pp. 849-854 ◽  
Author(s):  
Funda Saglam ◽  
Caner Cavdar ◽  
Sezer Uysal ◽  
Zahide Cavdar ◽  
Taner Camsari
Keyword(s):  
Oxidative Stress ◽  
Peritoneal Dialysis ◽  
Intravenous Iron ◽  
Iron Sucrose ◽  
Dialysis Patients

scholarly journals A study of efficacy and safety of intravenous iron sucrose for the treatment of moderate anaemia in antenatal women in South India

2017 ◽  
Vol 6 (7) ◽  
pp. 1655
Author(s):  
Venkata Ramana Vundi ◽  
Madhavi Pudutha ◽  
Chandrakala Kambar
Keyword(s):  
Iron Deficiency ◽  
Intravenous Iron ◽  
Medical Problem ◽  
Iron Sucrose ◽  
P Value ◽  
Study Group ◽  
Rapid Improvement ◽  
Chi Square ◽  
Iv Iron ◽  
Student’S T

Background: Iron deficiency anaemia in pregnancy is a common medical problem throughout India with the burden of disease impacting on both mother and the newborn. The WHO technical group working on the prevention and treatment of anaemia has documented that parenteral iron therapy has produced a rapid and better correction of iron deficiency anaemia.Methods: A total of 61 antenatal women in the age group of 18-25yrs were enrolled and randomly assigned into study group. For a period of 4 weeks, study group received iron sucrose intravenously. The results were noted, tabulated, analysed and expressed as descriptive statistics. Student's ‘t’ test and percentages were compared using chi square test. P -value, <0.001 was considered significant. The results were analysed by using SPSS V-21 software.Results: Mean rise of Hb was 2.51±0.44 with IV iron sucrose this was highly significant (HS). Mean rise of MCV was 8.02±6.72 with IV iron sucrose this was not significant (NS). Mean rise of PCV was5.7±2.77 with IV iron sucrose. These findings showed improvement in Hb and PCV which were statistically highly significant (HS). Adverse effects were 14% in the group.Conclusions: The present study proved that iron sucrose when given intravenously there was a rapid improvement in anaemia. IV iron sucrose was proved to be safe with minimal side effects.

scholarly journals A COMPARATIVE STUDY OF INTRAVENOUS IRON SUCROSE VERSUS ORAL IRON THERAPY IN IRON DEFICIENCY ANEMIA DURING POSTPARTUM PERIOD

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Satish Kumar
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Serum Ferritin ◽  
Intravenous Iron ◽  
Hemoglobin Level ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Deficiency Anemia ◽  
Iron Group ◽  
Iv Iron

Introduction: Anemia is the commonest major contributing factor in maternal mortality and morbidity in developing countries and according to World Health Organization (WHO) criteria, it contributes to 20% of maternal deaths. Anemia in pregnancy defined as hemoglobin level <11 gm/dl (7.45 mmol/L) and hematocrit less than 33% (WHO). Aim: To compare the efficacy of oral iron ferrous sulphate therapy with intravenous iron sucrose therapy in the treatment of iron deficiency anemia during postpartum period. Material & Methods: This was a prospective randomized comparative clinical trial single center study conducted on 200 postpartum women aged >18 years (after normal delivery or LSCS) within 10 days of delivery with Hb level more or equal to 6 gm/dl but less than 10 gm/dl were included in the study. This was a one year study conducted during 1st December 2018 to 30th November 2019. Results : There was a significant increase in the hemoglobin level in both the groups i.e. in IV iron group, from 8.26 ±1.03gm/dl on day 1 to 11.62±0.94gm/dl on day 45 as compared to oral iron group, from 8.24±1.09gm/dl on day 1 to 11.07±1.14gm/dl on day 45; and serum ferritin level from 41.69±40.45ng/ml on day 1 to 77.34±41.60ng/ml on day 45 in IV iron group as compared to the oral iron group from 22.20±8.82ng/ml on day 1 to 31.72±9.72 ng/ml on day 45. So, there was a rapid increase in both hemoglobin and serum ferritin levels in IV iron group as compared to the oral iron group. Conclusion: Intravenous iron sucrose administration increases the hemoglobin level and serum ferritin more rapidly in compare to the oral intake of ferrous sulphate in women with iron deficiency anemia in postpartum women in our study. Keywords: Iron deficiency anemia, Intravenous iron sucrose, Serum ferritin, Maternal mortality.

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