iron therapy
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2022 ◽  
Vol 7 (1) ◽  
pp. 573
Author(s):  
Shella Violita Sambodo ◽  
Nunuk Mardiana

Abstrak Latar belakang: Anemia merupakan salah satu komplikasi yang sering terjadi pada pasien dengan penyakit ginjal kronis dan sering mengakibatkan terjadinya penurunan kualitas hidup pasien, peningkatan morbiditas dan mortalitas pasien, serta meningkatkan laju progresivitas pada PGK. Pada pasien PGK stadium terminal, biasa disebut ESRD. Terapi pengganti ginjal untuk pasien ESRD salah satunya adalah hemodialisis. Tujuan: Untuk mendeskripsikan karakteristik pasien anemia pada ESRD dengan hemodialiasis di Instalasi Hemodialisis RSUD Soetomo Surabaya. Metode: Penelitian ini merupakan penelitian deskriptif observasional dengan metode cross sectional menggunakan data sekunder dari rekam medis pasien di Instalasi Hemodialisis RSUD Dr. Soetomo Surabaya. Hasil: Data dari 80 subjek penelitian, terdapat 17 orang (21,3%) berusia 18-40 tahun, berusia 41-60 dengan jumlah 53 orang (66,3%), dan usia > 60 tahun sebanyak 10 orang (12,5%) dengan hasil rerata usia 48,08 ± 10,598. Berdasarkan jenis kelamin pada pria ada 39 orang (48,8%), dan pada wanita 41 orang (51,2%), rerata jenis kelamin pria 9,46 ± 1,592 dan wanita 9,04 ± 1,329. Jenis penyakit komorbid yang paling banyak adalah hipertensi sebesar 49 orang (61,3%) dan yang paling sedikit adalah penyakit autoimun (lupus) dan glomerulonefritis serta urolithiasis yaitu 2 orang (2,5%).Total Saturasi Transferin (ST) terbanyak dengan kadar ST > 20% sejumlah 52 orang (65%) dan pada ST < 20% sebanyak 28 orang (35%). Subjek penelitian yang mendapatkan terapi eritropoietin (EPO) yaitu terdapat 55 orang (68,75%). Subjek penelitian yang mendapatkan terapi zat besi intravena (IV) sebesar 25 orang (31,25%).                                                                                                                                                                                                  Kesimpulan: Pasien anemia pada ESRD terbanyak pada interval usia 41-60 tahun, dengan jenis kelamin dominan pada wanita, dengan penyakit komorbid terbesar adalah hipertensi, dengan hasil ST dominan yaitu ST > 20, dan terdapat lebih banyak pasien yang menerima terapi EPO dibandingkan dengan menerima terapi zat besi intravena (dialifer). ---- Abstract Background: Anemia is a one of complication that often occurs in patients with chronic kidney disease and often results in a decrease in the patient's quality of life, an increase in patient morbidity and mortality, and an increase in the rate of progression of CKD. In patients with terminal stage CKD, it is known as ESRD. One of the renal replacement therapies for ESRD patients is hemodialysis. Objective: To describe the characteristics of anemia patients in ESRD with hemodialiasis at the Hemodialysis Installation of Dr. Soetomo General Hospital Surabaya. Methods: This research is a descriptive observational study with a cross sectional method using secondary data from the medical records of patients at the Hemodialysis Installation in Dr. Soetomo General Hospital Surabaya. Results: Data from 80 research subjects, there are 17 people (21.3%) aged 18-40 years, aged 41-60 with a total of 53 people (66.3%), and age > 60 years as many as 10 people (12.5 %) with a average age of 48.08 ± 10.598. Based on gender, there were 39 men (48.8%), and 41 women (51.2%), the average gender was 9.46 ± 1.592 for men and 9.04 ± 1.329 for women. The most common type of comorbid disease was hypertension by 49 people (61.3%) and the least was autoimmune disease (lupus) and glomerulonephritis and urolithiasis, namely 2 people (2.5%). ST > 20% a total of 52 people (65%) and on ST <20% as many as 28 people (35%). The research subjects who received erythropoietin (EPO) therapy were 55 people (68.75%). The research subjects who received intravenous (IV) iron therapy were 25 people (31.25%). Conclusion: The most anemia patients in ESRD were at the age interval of 41-60 years, with the dominant gender in women, with the largest comorbid disease being hypertension, with a dominant ST result of ST > 20, and there were more patients receiving EPO therapy compared to receiving intravenous iron therapy (dialifer).        


2022 ◽  
Vol 9 (1) ◽  
pp. 58-63
Author(s):  
Qandeela irum Qureshi ◽  
Basit Hashmi ◽  
Ahmed Siddique Ammar ◽  
Shehrbano Khattak ◽  
Sahar Saeed ◽  
...  

OBJECTIVES: The objective of this study was to determine frequency of non-compliance to oral iron therapy in pregnancy and common factors leading to it. METHODOLOGY: It was a cross-sectional study done in the Department of Obstetrics and Gynecology of Lady Willington Hospital Lahore, Pakistan. The duration of this study was six months i.e., 3rd October 2019 to 2nd March 2020. All antenatal patients between ages of 18 to 45 years presented in the obstetrics outdoors or admitted in the ward were included in this study. A total of 245 patients were included in this study by consecutive non-probability sampling. Patients with gynecological problems, patients dependent on others for their medication cost, patients with psychiatric illness or physical disability were excluded. Post stratification Chi-square test was applied keeping P-value ≤0.05 as significant RESULTS: Among 245 patients, mean age was 27±2.16 years. Iron supplement used by 245 patients was analyzed as 159 (65%) patients had used the iron supplement while 86 (35%) patients didn’t use iron supplements (P-value 0.001). Iron supplement used by 245 patients was analyzed and only 93 (38%) patients had used the iron supplement while 152 (62%) patients didn’t use iron supplements. CONCLUSION: The coverage of antenatal iron and folic acid supplements is very low in the surveyed districts of Pakistan due to lack of parental education and older aged women belonging to poor households.


Author(s):  
Sarah E. Detlefs ◽  
Michael D. Jochum ◽  
Bahram Salmanian ◽  
Jennifer R McKinney ◽  
Kjersti M. Aagaard

2021 ◽  
Author(s):  
Sumera Aziz Ali ◽  
Shama Razzaq ◽  
Savera Aziz ◽  
Ahreen Allana ◽  
Arzina Aziz Ali ◽  
...  

Abstract BackgroundIron deficiency anemia is a common public health problem problem among women of reproductive age (WRA) as it is can lead to unfavorable maternal and birth outcomes. Although studies are undertaken to assess the efficacy of iron, there are some gaps and limitations in the existing studies that need to be addressed. To address the gaps, we undertook a systematic review and meta-analysis to assess the existing evidence regarding the role of iron in decreasing anemia among WRA in low-middle-income countries.MethodsPubMed, Embase, and Science Direct were systematically searched using a comprehensive search strategy for randomized controlled trials published between 2000 to 2020. Mean change in hemoglobin level was assessed as a primary outcome. We performed a meta-analysis to estimate the pooled effect of all studies using standardized mean differences and their respective 95% CI. We assessed heterogeneity and publication bias using I2 statistics and Egger’s test respectively. This review was conducted with the help of updated guidelines based on the Preferred Reporting Items for Systematic Review and Meta-analysisResultsGenerally, the results demonstrated a favorable effect of iron therapy in improving hemoglobin levels with variation across studies. An overall pooled effect estimate for the role of iron therapy in decreasing the burden of anemia among WRA was -0.51 (95% CI: -1.03 to 0.01) (p = 0.04). Likewise, iron therapy improved ferritin levels and decreased the prevalence of anemia. The heterogeneity across included studies was found to be statistically significant as indicated by the parameters of heterogeneity (Q = 1191.60, I2 = 98.24%, p = 0.000). ConclusionIron therapy in any form may reduce the burden of anemia and improve the hemoglobin and ferritin levels, indicating improvement in iron-deficiency anemia. However, more evidence is needed to assess the morbidity associated with iron consumption such as side effects, work performance, economic outcomes, mental health, and compliance to the intervention with a special focus on married but non-pregnant women planning a pregnancy in near future. A systematic review and Meta-analysis registration: Registered with PROSPERO and ID is CRD42020185033


Author(s):  
Michael Auerbach ◽  
Iain C. Macdougall ◽  
George M. Rodgers ◽  
Tom Deloughery ◽  
Toby Richards
Keyword(s):  

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3076-3076
Author(s):  
Rebecka Hansen ◽  
Joergen Kurtzhals ◽  
Bjarne Styrishave ◽  
Charlotte Holm

Abstract Introduction: Hepcidin, the master regulator of iron economy, is decreased during pregnancy to facilitate adequate iron transfer across the placenta. Conversely, iron need increases substantially during pregnancy often leading to iron deficiency and subsequently anemia. The PREG-01 Study compared the efficacy and safety of intravenous (IV) ferric derisomaltose (FDI) vs. oral iron in treating persistent iron deficiency in pregnant women. The study found FDI to be efficacious and well-tolerated in pregnancy and the proportion of non-anaemic patients throughout the course of the study was significantly lower in the FDI group. In this analysis, we investigated the effect of baseline hepcidin on the response to IV and oral iron therapy. Methods: PREG-01 was a single-centre, open-label, randomized controlled trial. Women 14-21 weeks pregnant with persistent iron deficiency (ferritin&lt;30 µg/L despite oral iron treatment) received a single intravenous 1000 mg dose of FDI (n=100) or 100 mg elemental oral iron daily combined with ascorbic acid (n=101). Hemoglobin (Hb), ferritin and transferrin saturation (TSAT%) levels were captured at baseline and monitored throughout the study. The effect of baseline hepcidin on achieving non-anemic status (Hb ≥ 11 g/dL) at all study visits and the effect on change in Hb, ferritin and TSAT% were investigated by estimating odds ratios from a logistic regression model with treatment as factor and interaction between treatment and baseline hepcidin. The odds ratio estimate is for an increment in baseline hepcidin of 1 ng/mL. Results: Mean [standard deviation (SD)] baseline Hb was 11.97 (0.93) g/dL in the FDI group and 11.75 (0.91) g/dL in the oral iron group. Baseline hepcidin was 6.42 ng/mL in the FDI and 5.32 ng/mL in the oral iron group. Baseline hepcidin was not associated with the ability to achieve non-anaemic status either in the FDI (OR 0.98; 95% CI: 0.87-1.09) or the oral iron group (OR 0.96; 95% CI: 0.88-1.05). No statistically significant associations were found between baseline hepcidin and change in Hb, ferritin or TSAT% throughout the study (Figure 1). Conclusions: In a population of pregnant women with iron deficiency, but otherwise healthy, baseline hepcidin was overall low. Although there was a trend for an association between baseline hepcidin and Hb response to oral iron only, baseline hepcidin did not predict the response to iron therapy. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare. OffLabel Disclosure: Ferric Derisomaltose is an IV iron preparation indicated for the treatment of iron deficiency anemia in the US.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4214-4214
Author(s):  
Mustafa A Al-Tikrity ◽  
Ruaa W. Attaa ◽  
Arwa E Alsaud ◽  
Hussam A Almasri ◽  
Mohammad N Kloub ◽  
...  

Abstract Prevalence of Thrombocytopenia among Iron Deficiency Anemia in Arab population in Qatar INTRODUCTION / BACKGROUND Iron deficiency anemia is a common cause of anemia, and account for almost half of the causes of all anemias. It is well known and common that iron deficiency anemia can be with thrombocytosis, A study reviewed 450 patients with a diagnosis of anemia between 2002 and 2006 was performed in which 143 of them were having IDA found that 31% of them were having associated thrombocytosis (4). A retrospective study conducted in Turkey found that Iron deficiency anemia and thrombocytopenia found in 13 from 615 patients (2.1%) (5). IDA and thrombocytopenia are found in certain ethnicity where we don t have data from studies about Arab Population. Materials and Methods We retrospectively reviewed the electronic medical records of patients attended hematology/ IV iron room clinics with the diagnosis of IDA over 2 years from the period between December 2017 to December 2019 in Hamad Medical Corporation, Qatar. Complete blood count and iron parameters were collected and analyzed. Thrombocytopenia was defined as Platelet count of less than 150 × 109/L. Statistical analysis was done using mean and SD and paired t test to compare variables after versus before treatment. Depending on previous studies available in the literature, the prevalence of IDA and thrombocytopenia reported from the study done in Turkey (2.1%), based on this we expect the prevalence estimates in Arab population is 3% (with margin of error +/- %) and confidence level 95%, the required sample size needed would be a total of 1744 participants +- 0.8. The adequate sample size was determined using the following statistical equation: Inclusion Criteria: Arab Female who is diagnosed with iron deficiency anemia or iron depleted and receive iron therapy. Exclusion criteria: Extreme age less than 18 and above 65Any chronic organ dysfunction or failurePrevious bariatric surgery or gastrostomyMalignancy (Known or discovered at any time during study follow up) Results: Out of 1752 cases of IDA, 39 cases had thrombocytopenia, (2.2 %) (table 1) with mean age of 41.38. The mean Platelet count was 108 x 10^9 in patients with thrombocytopenia while it was 325 x 10^9 in non-thrombocytopenia patients. Platelets count mean increased to 179 x 10^9 after iron replacement (p &lt; 0.05). Analysis of thrombocytopenia according to nationalities was obtained which showed 28 cases among Qatari's (2.2%), 4.1 % in Egyptians, 3.8% in Yemenis, 3.1% Sudanese, 2.9%,2.7% in Jordanian and Syrian respectively and 1.1% in other nationalities (table 2). Discussion: Qatar is multinational country with large number of expatriates working in it. In our study thrombocytopenia occurred in 39 cases out of 1752 cases included in the study which represent 2.2% of them. Most of our patients were of Qatari nationality 1327 in which 28 cases of thrombocytopenia were found, with 3.8 % in Egyptian the 2nd most common Arab residents in Qatar. Further analysis according to nationalities revealed 3.1%, 2.9%, 2.7% in Yemenis, Sudanese and Jordanian patients, with 1.1% in other patients from other Arab nationalities. Comparison of blood parameters including platelet count before and after iv iron therapy were obtained which showed mean platelet count was 108 x 10^9 which increased to 179 x 10^9 after iron therapy, The mechanisms for the thrombocytopenia associated with IDA are not well established, although iron plays a critical role both in the synthesis of platelets and in the regulation of thrombopoiesis. Other blood parameters including WBC, ANC, Lymphocyte count showed decremental responses after iron therapy with WBC dropped from 6.3 to 6.1, ANC from 3.5 to 2.7 and lymphocyte count from 1.9 to 1.8 in thrombocytopenic patients. Conclusion: The prevalence of thrombocytopenia among IDA in Qatar was 2.2%, which normalized after iv iron therapy. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.


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