Total dose infusion iron dextran therapy in predialysis chronic renal failure patients.
BACKGROUND
Intravenous iron therapy is now the standard modality of iron supplementation in hemodialysis patients, but its role in predialysis chronic renal failure patients is less well established. The efficacy and safety of intravenous iron dextran as a total dose infusion in predialysis chronic renal failure patients, not receiving erythropoietin was assessed in this study.


METHODS
Fifty-six predialysis chronic renal failure patients with anemia, not receiving erythropoietin were included in the study, after obtaining informed consent. Hemoglobin, serum creatinine, creatinine clearance rate and serum ferritin were assessed in all the patients at baseline. Iron dextran in a dose of 1 g dissolved in 500 mL normal saline was administered to all patients as a total dose infusion over 6 h after a prior test dose. Patients were kept in hospital under observation for at least 24 h. All the parameters were repeated in all the patients at 12 weeks and in 21 patients at 1 year.


RESULTS
The mean hemoglobin (g/dL) in the patients at baseline and at 12 weeks was 8.28 +/- 0.57 and 9.22 +/- 0.44 respectively (p < 0.001). The mean serum ferritin (ng/mL) increased from 29.73 +/- 9.38 at baseline to 218.43 +/- 15.66 at 12 weeks (p < 0.00001). The mean ferritin value in the 21 patients at 1 year was 136.5 +/- 23.4 (p < 0.01). There were no major adverse events and only minor side effects were observed in 4.9% patients.


CONCLUSIONS
Iron dextran as a total dose infusion corrects anemia in predialysis patients and is an effective method to replenish iron stores. The effect on serum ferritin are evident even at 1 year after the total dose infusion.
Anuradha
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S
Dept. of Medicine, Maulana Azad Medical College and Associated, Lok Nayak Hospital, New Delhi, India. dr_anu55@hotmail.com
Singh
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NP
Agarwal
S K
SK
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D003404:Creatinine / Q000097:blood; D003971:Diastole / Q000187:drug effects / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D004341:Drug Evaluation; D005260:Female; D005293:Ferritins / Q000097:blood / Q000187:drug effects; D006454:Hemoglobins / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007194:India; D007262:Infusions, Intravenous; D007505:Iron-Dextran Complex / Q000008:administration & dosage / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012449:Safety; D013599:Systole / Q000187:drug effects / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D006454:Hemoglobins; D007505:Iron-Dextran Complex; D005293:Ferritins; D003404:Creatinine