Correction of haemodialysis-associated anaemia by deferoxamine. Effects on serum aluminum and iron overload.
Aluminium and iron overload is often seen among long-term haemodialysis patients. Untreated non-de-aluminized dialysis water or the intake of large amounts of aluminium hydroxide as phosphate binders are the most common reasons for hyper-aluminaemia. Iron overload is mainly a result of multiple blood transfusions given to correct renal anaemia. In chronic dialysis patients, hypochromic anaemia is one of the clinical manifestations of a long-term overload of aluminium and perhaps of other metals, e.g. iron. We used deferoxamine (DFO) to chelate aluminium and excessive iron in 17 patients on chronic haemodialysis. Two grams of DFO was administered weekly in the form of an i.v. infusion during the last hour of the dialysis session. The mean serum aluminum concentration decreased from 407.3 micrograms/l to 184.2 micrograms/l within 3 years of treatment, the mean serum ferritin concentration from 1,563 micrograms/l to 487 micrograms/l within 2 years. Anaemia was corrected concomitantly with an increase in the haemoglobin level, which rose from 71.7 g/l to 80.8 g/l. The mean corpuscular volume increased from 83.8 fl to 91.3 fl. The need for blood transfusion also decreased significantly in all patients after the institution of DFO therapy. The clinical manifestations of aluminium and iron overload disappeared and the quality of life improved. No major side-effects were observed.
von Bonsdorff
M
M
Fourth Department of Medicine, Helsinki University Central Hospital, Finland.
Sipilä
R
R
Pitkänen
E
E
D000328:Adult; D000536:Aluminum Hydroxide / Q000633:toxicity*; D000747:Anemia, Hypochromic / Q000139:chemically induced* / Q000188:drug therapy / Q000628:therapy; D001803:Blood Transfusion; D003676:Deferoxamine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007501:Iron / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects*
D000536:Aluminum Hydroxide; D007501:Iron; D003676:Deferoxamine