title: The safety and efficacy of an accelerated iron sucrose dosing regimen in patients with chronic kidney disease.
abstract: BACKGROUND
  Provision of adequate iron to support erythropoiesis in patients with chronic kidney disease (CKD) is time consuming and may present adherence problems for patients in the outpatient setting. We studied an accelerated regimen of high-dose intravenous iron sucrose therapy in a cohort of iron-deficient, anemic CKD patients.
  
  
  METHODS
  Intravenous iron sucrose 500 mg was infused over three hours on two consecutive days in 107 CKD patients (glomerular filtration rate, 32.3 +/- 19.6 mL/min/1.73m2, baseline hemoglobin 10.2 +/- 1.7 g/dL). Iron indices (transferrin saturation, ferritin) were measured at baseline and at two and seven days after completion of the iron regimen. Blood pressures were monitored immediately prior to, and hourly throughout the iron sucrose infusions.
  
  
  RESULTS
  Transferrin saturation and serum ferritin increased from 18.5 +/- 8.5% and 177 +/- 123.8 ng/mL at baseline to 40.2 +/- 22.3% and 811 +/- 294.1 ng/mL in 102 evaluated patients (P < 0.015). In 55 patients with additional measurements at 7 days post-dosing, the transferrin saturation and ferritin had fallen to 26.3 +/- 10.6% and 691 +/- 261.8 ng/mL (P < 0.015 compared to two days' post-dose). Blood pressure rose slightly, but not significantly, throughout the infusions, and altering the infusion rate was not necessary. Two patients had seven adverse events that were considered related to iron sucrose.
  
  
  CONCLUSIONS
  An accelerated regimen of high-dose intravenous iron sucrose therapy in CKD patients is safe and effective in restoring iron stores, and may potentially save time and improve patient adherence.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, The Long Island College Hospital, Brooklyn, New York 11201, USA. danisil@mindspring.com
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Blaustein
authors.forename: Michael H
authors.initials: MH
authors.lastname: Schwenk
authors.forename: Jyoti
authors.initials: J
authors.lastname: Chattopadhyay
authors.forename: Harinder
authors.initials: H
authors.lastname: Singh
authors.forename: Rachid
authors.initials: R
authors.lastname: Daoui
authors.forename: Radjeep
authors.initials: R
authors.lastname: Gadh
authors.forename: Morrell M
authors.initials: MM
authors.lastname: Avram
mesh_terms: D000368:Aged; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage* / Q000009:adverse effects*; D000077605:Ferric Oxide, Saccharated; D005293:Ferritins / Q000097:blood; D005937:Glucaric Acid; D006801:Humans; D007262:Infusions, Intravenous; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014168:Transferrin / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D005290:Ferric Compounds; D014168:Transferrin; D005293:Ferritins; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid