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Iron overdose: a contributor to adverse outcomes in randomized trials of anemia correction in CKD.

Abstract：

:Administration of intravenous iron to supplement erythropoiesis stimulating agents (ESAs) has become a common practice in the management of anemia in patients with end-stage renal disease. Randomized clinical trials of anemia correction in this population have shown more adverse outcomes in CKD and ESRD patients assigned to the higher hemoglobin targets. Retrospective analysis of these trials suggests that morbidity is higher in subjects who fail to achieve the designated hemoglobin target and are typically exposed to higher doses of ESAs and iron than those that easily achieve the intended targets. Intravenous iron administration circumvents the natural biologic mechanisms for handling and utilization of iron. There is in vitro and in vivo evidence that intravenous iron preparations can cause oxidative stress, endothelial dysfunction, inflammation, impaired immunity, and renal injury. Since iron overload is known to promote endothelial dysfunction, cardiovascular disease, and immune dysfunction which are the leading causes of premature mortality in CKD and ESRD patients, it is imperative to exercise caution with the use of IV iron preparations in this population. The present review is intended to provide a brief overview of the potential adverse effects of the overzealous use of these agents.

journal_name

Int Urol Nephrol

journal_title

International urology and nephrology

authors

Van Buren P,Velez RL,Vaziri ND,Zhou XJ

doi

10.1007/s11255-011-0028-5

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

499-507

issue

2

eissn

0301-1623

issn

1573-2584

journal_volume

44

pub_type

杂志文章,评审

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