Intravenous iron hydroxysaccharate: Establishing the optimum dose.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:217A 1997
Intravenous iron therapy has become recognized as an important adjunct therapy in the treatment of anemia in hemodialysis patients. Iron dextran has been associated with allergic reactions, however, which has limited its overall acceptance. In Europe, two other parenteral iron preparations have been in use for decades. One of the authors of this study, Dr. Ian Macdougall has had long experience with the use of iron saccharate, and has been a leader in anemia research in ESRD. The purpose of this study was to determine the optimal dose of iron saccharate. Three regimens were studied, single dose infusions of 200, 300, and 500 mg. The 500 mg dose was associated with free iron reaction symptoms such as nausea and hypotension in 8 of 22 patients studied. At a dose of 300 mg, no problems were encountered. Therefore, the authors concluded that 300 mg was the optimum dose.
Comment: The two iv iron medications used extensively in Europe, iron saccharate and ferric gluconate, both appear to cause less allergic reactions than iron dextran. However, both release iron more freely, leading to potential problems such as hypotension. With both agents, therefore, the maximal dose, and rate of administration are limited. This study demonstrates that an iv infusion of iron saccharate of up to 300 mg seems to be well tolerated, without significant free iron problems. (Stephen Fishbane, M.D., Winthrop University Hospital, Mineola, NY)
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ASN 30th Annual Meeting, San Antonio
CRF by problem area : Anemia/Erythropoietin/Iron