[Efficacy of bolus intravenous iron treatment in peritoneal dialysis patients].
BACKGROUND
Normocytic, normochromic anemia is one of the first signs of chronic renal failure and it is common in patients on chronic dialysis treatment. It causes decrease in oxygen supply to tissues, increases cardiac minute volume, causes left ventricular hyperthrophy, cardiac insufficiency, disorders related to cognitive functions and immune response, and increases morbidity and mortality rates. The leading cause of anemia in patients on chronic peritoneal dialysis (PD) is iron depletion and most patients on PD need oral or parenteral iron supplementation. The aim of this study was to evaluate our first experience with bolus intravenous ferrogluconate therapy in patients on chronic peritoneal dalysis at the Nephrology Clinic of the Clinical Center of Serbia (CCS).


METHODS
We examined 11 patients, 7 males and 4 females, mean-age 49 years (range 31 to 68 years) on chronic PD. All patients received blood transfusions, oral or intramuscular iron supplementation before 465 to 665 mg ferrogluconate therapy was given in 500 ml. saline intravenous infusion: 5 of them were on erythropoietin therapy and 2 of them started with EPO therapy after the ferrogluconate therapy.


RESULTS
The blood count improved during the first 3 months after application of bolus intravenous iron therapy (ferrogluconate); erytrhopoietin dose was not increased during the follow-up. Some patients suffered from side effects during infusion and 6 patients received the complete treatment.


CONCLUSIONS
Blood count improves in a number of patients affected by endstage renal desease during the first months on continuous ambulatory peritoneal dialysis (CAPD) treatment. But a large number of patients on chronic CAPD treatment are iron-depleted and they require oral or parenteral substitution. Side effects and complications of intravenous iron therapy were not severe and only one patient suffered from allergic manifestations. Ferremia and blood count improved in patients who did not receive erythropoietin during the follow-up, and patients on erythropoietin therapy required lower doses after receiving the intraveonous iron therapy.


CONCLUSIONS
Blood count improvement and the lack of severe side effects speak in favor of further iron supplementation with bolus intravenous iron replacement.
Jovanović
Natasa
N
Klinicki centar Srbije, Beograd Nefroloska klinika. naca@absolutok.net
Lausević
Mirjana
M
Nesić
Vidosava
V
Grujić-Adanja
Gordana
G
Stojimirović
Biljana
B
D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005296:Ferrous Compounds / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects; D010531:Peritoneal Dialysis, Continuous Ambulatory
D005296:Ferrous Compounds; C011819:ferrous gluconate