Iron sucrose causes greater proteinuria than ferric gluconate in non-dialysis chronic kidney disease.
Non-dextran intravenous (i.v.) iron preparations seem to differentially affect proteinuria in patients with chronic kidney disease. To study effects of ferric gluconate and iron sucrose on proteinuria, we conducted a crossover trial in 12 patients with stage 3-4 chronic kidney disease. These patients were randomized to receive the same dose of either drug 1 week apart. Urine samples were obtained immediately before and at frequent intervals after the drug. The urine total protein/creatinine ratio was significantly greater after iron sucrose than ferric gluconate treatment with the effect noted within 15 min post-infusion. Furthermore, when iron sucrose was given first, a significantly greater protein/creatinine ratio was seen subsequently with ferric gluconate than with the reverse order of treatment. The urine albumin/creatinine ratio was also significantly greater with iron sucrose than with ferric gluconate. There was no significant difference, however, between the two i.v. irons in the measured urine N-acetyl-beta-D-glucosaminidase/creatinine ratio. Although our study showed that acutely, iron sucrose increased proteinuria, the long-term effects of repeated i.v. non-dextran iron on kidney function requires further study.
Agarwal
R
R
Department of Medicine, Indiana University School of Medicine and Richard L Roudebush VA Medical Center, 1481 West 10th Street, Indianapolis, IN 46202, USA. ragarwal@iupui.edu
Rizkala
A R
AR
Kaskas
M O
MO
Minasian
R
R
Trout
J R
JR
D000368:Aged; D018592:Cross-Over Studies; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage* / Q000627:therapeutic use; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid; D006801:Humans; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000188:drug therapy*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy*; D016896:Treatment Outcome
D005290:Ferric Compounds; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid; C035552:ferric gluconate