title: Efficacy and tolerability of accelerated-dose low-molecular-weight iron dextran (Cosmofer) in patients with chronic kidney disease.
abstract: BACKGROUND
  The Renal NSF advocates correction of anaemia in chronic kidney disease patients. Oral iron is often insufficient, while intravenous supplementation replenishes and maintains iron stores. There is a need to administer high doses of iron in a single rapid infusion to enable efficient costs, effective utilisation of time for patients and staff and optimal use of resources.
  
  
  METHODS
  We performed a prospective study of consecutive patients referred for iron dextran (Cosmofer) therapy. This was administered over 2 h 40 min compared with the normal regime of 4-6 h. Blood pressure was recorded throughout administration. Adverse drug reactions were recorded over 2 weeks. Serum ferritin, haemoglobin and estimated glomerular filtration rate were measured at baseline and 3 months.
  
  
  RESULTS
  One hundred patients (59 male, mean age 69 years), received a median dose of 1,000 mg Cosmofer in a median time of 2 h 40 min. Mean serum ferritin rose from 178 at baseline to 413 μg/l (p < 0.001). Mean haemoglobin rose by 1.5 g/dl (p < 0.001). There was no decline in estimated glomerular filtration rate after 3 months. No adverse reactions were noted.
  
  
  CONCLUSIONS
  We demonstrated that accelerated administration of iron dextran is safe and effective with no short-term effects on renal function. This resulted in a time saving of approximately 67 hours.
authors.affiliation: Department of Renal Medicine, Hull and East Yorkshire Hospital NHS Trust, Kingston upon Hull, UK.
authors.forename: M
authors.initials: M
authors.lastname: Cooke
authors.forename: A
authors.initials: A
authors.lastname: Lamplugh
authors.forename: S
authors.initials: S
authors.lastname: Naudeer
authors.forename: M
authors.initials: M
authors.lastname: Edey
authors.forename: S
authors.initials: S
authors.lastname: Bhandari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003911:Dextrans / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007676:Kidney Failure, Chronic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D008970:Molecular Weight; D010865:Pilot Projects; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D003911:Dextrans