scholarly journals CORRECTING OF ANEMIA USING IRON SUCROSE IN PATIENTS WITH CHRONIC KIDNEYDISEASE STAGE VD ON HEMODIALYSIS

Author(s):  
I. Dudar ◽  
I. Shifris ◽  
Y. Gonchar ◽  
V. Savchuk ◽  
O. Loboda ◽  
...  

Anemia is a common complication of CKD. Iron deficiency is one of a leading cause of anemia in HD patients. The causes of iron deficiency in these patients are multifactorial. Main factors that contribute to iron deficiency in HD patients are reduction intake and impaired intestinal absorption of dietary iron, blood losses, chronic inflammation and increased iron requirements during therapy with erythropoiesis–stimulating agents. Aim.The aim was to study efficacy and safety of iron sucrose (Venofer) in HD patients with anemia. Materials and methods. This study was an retrospective, epidemiologic, performed from 2010 to 2014 years. The study included 69 HD patients with anemia from dialysis single–center. 38 (55.1%) patients were men, average age 49,53 ± 3,9years and the most common cause of ESRD was glomerulonephritis (37 patients, 53.6%). Hemoglobin value was analyzed weekly. The levels of serum ferritin and transferrin saturation, were determined before and after treatment with Venofer. Results. Treatment with the Venofer resulted a significant increase of hematological and iron exchange parameters. At 2 – 3 weeks of therapy, hemoglobin levels increased by 7,6% and 10,7%, respectively. 14 days after the last dose Venoer serum ferritin and transferrin saturation levels have increased by 58% and 55%, respectively. Conclusions. Intravenous iron is the preferred route of administration in HD patients. Venofer showing a significant increase both of hemoglobin and iron exchange markers levels on a background of insignificant frequency of treatment–related adverse events.

Author(s):  
Divyani Agrawal ◽  
Deepa Lokwani Masand

Background: Anemia is one of the common manageable problem among the pregnant women worldwide, which contributes to maternal and perinatal mortality. This study aims to compare the efficacy and safety of intravenous ferric carboxymaltose with intravenous iron sucrose in treating anemia during pregnancy. Objective of this study was to compare safety and efficacy of intravenous ferric carboxymaltose with intravenous ferric sucrose in iron deficiency anemia during pregnancy.Methods: It’s an interventional prospective study conducted in Department of Obstetrics and Gynecology at NIMS, Jaipur, Rajasthan, India constituting of 100 pregnant women. Group 1- 50 pregnant women were treated with intravenous ferric carboxymaltose and Group 2: 50 pregnant women were treated with intravenous iron sucrose. Hemoglobin and serum ferritin levels were measured pre and post treatment with parenteral iron therapy. The efficacy of intravenous ferric carboxymaltose in comparison to intravenous iron sucrose was assessed. The evaluation of safety and tolerance with the parenteral therapy was also performed.Results: Anemia during pregnancy was more prevalent among the reproductive age group and in multiparous women. The mean rise in the hemoglobin level with ferric carboxymaltose was 2.92 gm/dl and with that of iron, sucrose was 1.08 gm/dl. The man rise in the serum ferritin levels with ferric carboxymaltose was 64.97ng/ml and with iron sucrose was 31.64 ng/ml. Ferric carboxymaltose was observed to be safer with no adverse events in comparison to the Iron sucrose which was related with adverse events among 03 pregnant women.Conclusions: Intravenous ferric carboxymaltose was more efficacious and safer in comparison to intravenous iron sucrose among pregnant women. Hence, ferric carboxymaltose is the drug of choice in treatment of iron deficiency anemia during pregnancy.


2017 ◽  
Vol 8 (5) ◽  
pp. 31-35
Author(s):  
Harsha Shailesh Gaikwad ◽  
Anu Sindhu ◽  
Nivedita Sarda

Background: Iron deficiency anemia due to poor nutritionis estimated to affect nearly two thirds ofall pregnant women in developing countriesparticularly in India. The responsible constellation of factors producing iron deficiency anemia generally precede the pregnancy, which includedeficient diet in iron content coupled with menstrual losses,generally a rapid succession of pregnancies and inadequate supplemental iron are a few to be blamed for a high incidence of anemia in such population.Aims and Objectives: To compare the efficacy and safety of iron sucrose versus iron sorbitol therapy in pregnant anemic patients.Material and Methods: Two-hundred antenatal women attending the out patient department having hemoglobin levels of 8 gm% or less were recruited in the study and were randomized into two groups for receiving intravenous and intramuscular iron therapy.Results and Conclusions: There was a significant improvement in the haematologicalparameters and no major side effects developed in the intravenous iron sucrose group.Though there was a significant improvement in the haematological parameters after intramuscular iron sorbitol therapy also butnone of the cases reached the target level of haemoglobinduring the observation period.Asian Journal of Medical Sciences Vol.8(5) 2017 31-35


Author(s):  
Satish Kumar

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.


Author(s):  
K. P. Poojitha ◽  
B. S. B. Mallika ◽  
K. V. Siva Prasad

Background: Prevalence of iron deficiency anaemia is high in developing countries like India. Treatment of iron deficiency anaemia in pregnancy is very important to bring down maternal mortality rate as blood loss during delivery can lead to death of the patient. The aim and objective of our study is to evaluate the efficacy and safety of intravenous iron sucrose infusions in antenatal women admitted in hospital suffering from moderate iron deficiency anaemia. Special emphasis was given to observe adverse drug effects.Methods: This was a prospective observational study conducted in Obstetrics and Gynaecology department, Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh. Study period was two months and study population included antenatal women with gestational age less than 37 weeks with moderate iron deficiency anaemia. Peripheral smear was examined for microcytic hypochromic anaemia and they were treated with intravenous infusion of iron sucrose. Haemoglobin levels were checked before and 5 weeks after iron infusions. Monitoring was done for adverse reactions.Results: Out of 322 admissions, 95% were found to be anaemic. 72 patients were suffering from moderate anaemia from which 25 have been included and treated with intravenous iron sucrose infusions. They were observed for efficacy and safety parameters. Two minor adverse events were reported (fever with chills and angioedema of lips) and they were excluded from study. Mean haemoglobin concentration was found to be raised from 7.08±0.73 (SD) to 11.33±0.48 (SD) within 5 weeks for 23 patients.Conclusions: Iron sucrose infusion is safe and effective for anaemia in pregnancy.


2000 ◽  
Vol 11 (3) ◽  
pp. 530-538
Author(s):  
ANATOLE BESARAB ◽  
NEETA AMIN ◽  
MUHAMMAD AHSAN ◽  
SUSAN E. VOGEL ◽  
GARY ZAZUWA ◽  
...  

Abstract. Iron deficiency limits the efficacy of recombinant human erythropoietin (rhEPO) therapy in end-stage renal disease (ESRD) patients. Functional iron deficiency occurs with serum ferritin >500 ng/ml and/or transferrin saturation (TSAT) of 20 to 30%. This study examines the effects of a maintenance intravenous iron dextran (ivID) protocol that increased TSAT in ESRD hemodialysis patients from conventional levels of 20 to 30% (control group) to those of 30 to 50% (study group) for a period of 6 mo. Forty-two patients receiving chronic hemodialysis completed a 16- to 20-wk run-in period, during which maintenance ivID and rhEPO were administered in amounts to achieve average TSAT of 20 to 30% and baseline levels of hemoglobin of 9.5 to 12.0 g/dl. After the run-in period, 19 patients randomized to the control group received ivID doses of 25 to 150 mg/wk for 6 mo. Twenty-three patients randomized to the study group received four to six loading doses of ivID, 100 mg each, over a 2-wk period to achieve a TSAT >30% followed by 25 to 150 mg weekly to maintain TSAT between 30 and 50% for 6 mo. Both regimens were effective in maintaining targeted hemoglobin levels. Fifteen patients in the control group and 17 patients in the study group finished the study in which the primary outcome parameter by intention to treat analysis was the rhEPO dose needed to maintain prestudy hemoglobin levels. Maintenance ivID requirements in the study group increased from 176 to 501 mg/mo and were associated with a progressive increase in serum ferritin to 658 ng/ml. Epoetin dose requirements for the study group decreased by the third month and remained 40% lower than for the control group, resulting in an overall cost savings in managing the anemia. Secondary indicators of iron-deficient erythropoiesis were also assessed. Zinc protoporphyrin did not change in either group. Reticulocyte hemoglobin content increased only in the study group from 28.5 to 30.1 pg. It is concluded that maintenance of TSAT between 30 and 50% reduces rhEPO requirements significantly over a 6-mo period.


2002 ◽  
Vol 22 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Elisabeth Dittrich ◽  
Martin Schillinger ◽  
Gere Sunder–Plassmann ◽  
Walter H. Hörl ◽  
Andreas Vychytil

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.


2015 ◽  
Vol 7 (1) ◽  
pp. 18-21
Author(s):  
Ruchika Garg ◽  
Renu Rajvanshi

ABSTRACT Objective To evaluate the efficacy and safety of single dose intravenous iron carboxymaltose vs multidose iron sucrose in postpartum cases of severe iron deficiency anemia. Materials and methods One hundred cases with iron deficiency anemia in postpartum patient were selected from postpartum wards and assigned in two groups of 50 each. In group A, iron carboxymaltose injection administered by intravenous infusion upto a maximum single dose of 20 ml of iron carboxymaltose injection (1000 mg of iron). In group B Iron sucrose was given as 200 mg elemental iron (2 ampules of 5 ml) in 100 ml of 0.9% normal saline infusion over 15 minute alternate days up to 5 days. All the patients were monitored for rise in hemoglobin level at 2, 4, 8 and 12 weeks of iron therapy, adverse effect and rise in hematological parameter at 4 weeks. Results In group A, mean Hb level rise is 3.95 g/dl and in group B, it is 3.32 g/dl at 4 weeks of initial therapy. In group A, 100% cases achieved target Hb at 12 weeks after therapy while in group B 98% cases achieved target Hb at 12 weeks after therapy. In group A, 12% cases have grade 1 adverse reaction while in group B, 20% cases have adverse reaction. Conclusion Administration of intravenous iron has a good clinical result, with minimum adverse reactions. Thus, we can conclude that intravenous iron carboxymaltose therapy is safe, convenient, more effective and faster acting than intravenous iron sucrose for treatment of severe iron deficiency anemia in postpartum patient. How to cite this article Garg R, Singh S, Singh S, Rajvanshi R. A Comparative Study to Evaluate the Efficacy and Safety of Single Dose Intravenous Iron Carboxymaltose vs Multidose Iron Sucrose in Postpartum Cases of Severe Iron Deficiency Anemia. J South Asian Feder Obst Gynae 2015;7(1):18-21.


Author(s):  
Soniya Vishwakarma ◽  
Rajani Rawat ◽  
Pragati Dwivedi ◽  
Vaibhav Kanti

Background: Iron deficiency anaemia is one of the major morbidities during post-partum period. The aim of this study was to compare the efficacy, safety and compliance of intravenous iron sucrose complex with oral Iron therapy in treatment of postpartum anemia.Methods: 100 postpartum anaemic patients randomized into two groups. In Group I oral iron ferrous sulphate tablets twice daily and in group II 200 mg of iron sucrose on every alternate day up to total calculated dose for 6 weeks. Hemoglobin and serum ferritin were measured on day 0, 2 week and 6 weeks. The side effects in both groups were noted.Results: Majority of patients are multiparous, illiterate and belonged to low socioeconomic. Mean baseline hemoglobin in oral group (Group I) was 7.90±0.905 gm /dl and in i/v group (Group II) was 7.81±0.849 gm /dl. There was significant rise in hemoglobin and hematocrit in both groups after 2 weeks and 6 weeks. However, efficiency of iron sucrose was greater in between the groups (p value=0.0000). There was a rise in serum ferritin to 58.35±14.537μg/L from 8.30±1,461μg/L after 6 weeks in intravenous group with shorter duration of treatment indicating a high efficacy (p<0.001). Intravenous iron sucrose did not result in any serious adverse reactions.Conclusions: This study illustrates clearly that intravenous iron sucrose complex is safe, convenient and effective in postpartum anemic women as compared with oral ferrous sulphate.


2017 ◽  
Vol 1 (2) ◽  
pp. 31-35
Author(s):  
Shaheen Anjum ◽  
Nidhi Garg ◽  
Sri Beriwal ◽  
Anjum Parvez

ABSTRACT Objective To compare an accelerated high-dose (500 mg) vs low-dose (200 mg) regimen of intravenous iron sucrose in a cohort of iron-deficient anemic antenatal patients in terms of efficacy, safety, and compliance. Materials and methods In a prospective hospital-based study, antenatal and postnatal women with anemia attending Jawaharlal Nehru Medical College and Hospital, Aligarh, India, between December 2010 and December 2012 were enrolled. The inclusion criteria were all outpatient and admitted anemic antenatal women ≤ 36 weeks gestation and postnatal women with hemoglobin (Hb) below 10 gm/dL, or serum ferritin ≤ 30 μg/L or transferrin saturation ≤ 40% irrespective of prior oral iron therapy. Patients were excluded from the study if they were hemodynamically unstable, actively bleeding, having fever, or were nauseated or vomiting. Participants were assigned to control and study groups according to simple random sampling. Intravenous iron sucrose group I (500 mg)/group II (200 mg) was infused after test dose on alternate days for the calculated total dose in the study population. Blood and iron indices were measured at baseline and after 2 weeks of administration of last dose. The primary outcome of the study was to assess the rise in Hb and safety of high-dose intravenous iron sucrose. Results There was a statistically significant increase in Hb level in patients receiving either regimen, with larger mean increase in group I (2.7 ± 0.4) compared with group II (2.25 ± 6.39). Serum iron and serum ferritin also increased in both fortnightly (p < 0.001). Blood transfusion was avoided by 90.1% in severely anemic cases with Hb < 7. Hospital stay was reduced by 50% in group I. Conclusion The accelerated regimen of high-dose (500 mg) intravenous iron sucrose in anemic antenatal patients appears to be safe and effective in correcting anemia, restoring iron stores, and avoiding blood transfusion. How to cite this article Anjum S, Garg N, Beriwal S, Parvez A. High-dose Accelerated vs Low-dose Frequent Regime of Iron Sucrose Therapy in Antenatal and Postnatal Women with Iron Deficiency. World J Anemia 2017;1(2):31-35.


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