intravenous 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).        


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D Mouselimis ◽  
A Tsarouchas ◽  
C Bakogiannis ◽  
A Mitsas ◽  
D Tsalikakis ◽  
...  

Abstract Background Heart failure with reduced ejection fraction (HFrEF) is a disease that confers significant morbidity and mortality to patients. Patients suffer from increased arrhythmia burden; lethal ventricular arrhythmias are frequent. Iron deficiency (ID) is increasingly recognized as a common comorbidity that constitutes a further detriment to patients' cardiorespiratory capacity and an independent prognosticator of mortality. ID treatment with intravenous ferric carboxymaltose (IV FCM) has proven beneficial, improving QoL and exercise capacity in HFrEF patients with ID. Iron depletion is linked to disturbed myocyte electromechanical balance, especially in HF. However, the role of IV FCM arrhythmic burden in HFrEF patients with ID has not been examined. Purpose Investigate the effect of IV FCM treatment on the functional capacity, QoL and arrhythmic burden of in HFrEF patients with ID and cardiac implantable electronic devices (CIED). Methods HFrEF patients with ID and CIEDs were recruited from our outpatient HF clinic. CIED telemetry revealed their arrhythmic burden for the 6 months preceding IV FCM administration. Patients underwent physical examination, blood testing, 6-minute walk testing, 24-hour Holter monitoring, QoL quantification with the KCCQ and EQ-5D-5L questionnaires and repeat CIED telemetry at study baseline (IV FCM administration) and 6-months. Microvolt T-wave alternans (MTWA) and heart rate turbulence (HRT) slope and onset were quantified through the 24-hour ECG recordings. HRT results are reported as HRT0, HRT1 or HRT2 based on the number of abnormal HRT parameters. Results So far, 83 (aged 68.3±8.7 years, 82% male) out of a total of 96 recruited patients have completed the 6-month follow-up (3 of 83 died before the 6-month mark). Picture 1 contains patients' baseline characteristics and 6-month results. Patients received a mean of 1.43±0.61g of IV FCM during the follow-up period, which significantly ameliorated iron status (Picture 1). The 6MWD increased by 32.4m (95% CI: 14.7–47.2, P&lt;0.001), as did the KCCQ total score (P=0.008). Patients' CIEDs recorded significantly more nsVTs in the 6 months preceding IV FCM administration (2.2±15.7 per month) opposed to the subsequent period (0.06±3.1 per month, P=0.006). Patients' MTWA improved at 6-months over baseline (P=0.004), and a trend for improvement in HRT scores was observed (P=0.06). Hospitalization-free survival curves of these time periods reveal a non-significant trend for lower hospitalization risk following IV FCM (HR=1.9, P=0.09). Conclusions After 6 months of IV FCM treatment, HFrEF patients with ID had significantly better exercise capacity and quality of life. Regarding arrhythmias, a tentative improvement in CIED- and Holter-derived arrhythmic markers was observed. Extended follow-up of a larger sample size will provide further insight for the effect of IV FCM in these patients' arrhythmic burden. FUNDunding Acknowledgement Type of funding sources: None. Baseline and 6-month results Hospitalization curves pre-post IV FCM


Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1222
Author(s):  
Matteo Bolcato ◽  
Ivo Beverina ◽  
Daniele Rodriguez ◽  
Anna Aprile ◽  
Marco Trabucco Aurilio

This article analyzes the recommendations issued by the Emilia Romagna region in July 2020 on “Organizational strategies for the safe management of intravenous iron therapy in patients in non-hospitalized settings”. The objective of these recommendations is to set up safe intravenous iron administration sites outside the hospital environment across the national territory. The document facilitates the organization of methods for intravenous iron infusion that are safe for the patient and correct from a medico-legal perspective. In addition, it opens the way for the widespread use of iron infusion in the field, providing benefits to patient quality of life. This program prevents unnecessary transfusions, reduces costs, prevents overcrowding in hospitals in the event of a pandemic, and enables patient treatment in the field, thus, saving on the use of personnel.


Bone ◽  
2021 ◽  
pp. 116202
Author(s):  
Benedikt Schaefer ◽  
Moritz Tobiasch ◽  
Sonja Wagner ◽  
Bernhard Glodny ◽  
Herbert Tilg ◽  
...  

Author(s):  
Pardeep S. Jhund ◽  
Mark C. Petrie ◽  
Michele Robertson ◽  
Patrick B. Mark ◽  
Michael R. MacDonald ◽  
...  

2021 ◽  
Author(s):  
Hussam Almasri ◽  
Ashraf Soliman ◽  
Vincenzo Desanctis ◽  
Arwa Alsaud ◽  
Roua Alhashimy ◽  
...  

Abstract IntroductionIron deficiency anemia (IDA) is the most common cause of anemia in both developed and developing countries. Leukopenia is an infrequent side effect of iron therapy reported in the literature as sporadic cases. We conducted a study to clarify this issue and to check its consequences in a big cohort of patients with IDA.ObjectiveTo assess the relationship between iron therapy (intravenous) and leukopenia, neutropenia or lymphocytopenia, and its clinical impact, if any, on patients.Materials and Methodsthis is a retrospective study conducted in Hamad Medical Corporation, Doha/Qatar. the clinical and biochemical data of 1567 females with IDA who attended the hematology clinic and were treated with intravenous iron therapy were collected and analysed. Complete and differential blood counts and iron profile were studied before and after iron treatment. In addition, cases who developed infections during the time of leukopenia were noted and checked for possible complications.ResultsAfter iron therapy, out of 1567 case of iron deficiency anemia, 30 cases (1.914%) developed leukopenia,15 cases (0.957%) developed neutropenia and 12 cases (0.765%) developed lymphocytopenia. All had normal WBC counts before treatment. 2 patients (6.66%) had infection, 1 had upper respiratory tract infection and 1 urinary tract infection, the latter was treated with antibiotics. There were no reported infections during or after iron therapy.ConclusionsLeukopenia in form of neutropenia or lymphocytopenia may occur as a side effect of IV iron therapy, however, its clinical significance appeared to be limited.


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