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Article Review/Hyperlink |
Fishbane S, Ungureanu V-D, Maesaka JK, Kaupke CH, Lim V, Wish J
The safety of intravenous iron dextran in hemodialysis patients
Am J Kidney Dis (Oct) 28:529-534 1996
The treatment of anemia in hemodialysis patients is impeded by iron deficiency. Fishbane et al reviewed the records of 573 hemodialysis patients treated with iron dextran in four hemodialysis centers to determine the incidence and type of adverse reactions. They found that 4.7 % of patients experienced some adverse event attributable to iron dextran. Most reactions were mild and self-limited. Dyspnea or wheezing, itching, and chest pain were the most frequent complaints. Hypotension was reported in 0.5 % of patients. Adverse reactions were more frequent in patients with a history of multiple drug allergies. Four patients (0.7 %) experienced a serious adverse event. These serious reactions included one cardiac arrest and three episodes of hypotension, dyspnea, or chest pain that required hospitalization. There were no deaths.
Comment: This study is the only large and independent assessment of the safety of the new formulation of iron dextran. The investigation is well done and clearly reported and the results are similar to those published for previous formulations.
The authors have made several important observations. Adverse reactions to iron dextran are unusual and serious adverse events are rare. Their data suggest that a history of multiple drug allergies may predict these infrequent occurrences. Only a prospective study could be more convincing. (George R. Aronoff, M.D., University of Louisville, Kentucky)
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