title: [Safety aspects of parenteral iron supplementation therapies in patients with chronic kidney disease].
abstract: Iron deficiency often occurs in patients with chronic kidney disease and can be effectively treated with parenteral supplementation of iron. In these patients, prompt application of iron therapy can help to reduce the dependence of erythropoietin-stimulating agents and effectively treat anemia. Correct evaluation of iron metabolism in CKD patients can be difficult. Duration of and response to therapy should always be considered while planning parenteral supplementation of iron. The main safety aspects of parenteral iron preparations relate to their possible anaphylactic potential and the potential induction of oxidative stress due to the release of free iron. However, parenteral iron supplementation is usually safe and without major side effects. Regarding current data, none of the iron preparations is showing definitive superiority. Although uncommon, iron preparations containing dextran can lead to severe side effects, therefore these preparations appear to have an inferior safety profile. Due to limited data, a comparison of third-generation iron preparations with previous preparations is not possible. Recently, for the first time, the third generation iron preparation ferumoxytol has been directly compared to iron sucrose. From this data and others, it remains unclear whether third generation iron preparations show safety-relevant superiority.
authors.affiliation: Klinik für Nephrologie, Universitätsklinikum Düsseldorf. sebastian.potthoff@med.uni-duesseldorf.de
authors.forename: S A
authors.initials: SA
authors.lastname: Potthoff
authors.forename: H G
authors.initials: HG
authors.lastname: Münch
mesh_terms: D000284:Administration, Oral; D000707:Anaphylaxis / Q000139:chemically induced; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy*; D004187:Disaccharides / Q000009:adverse effects / Q000627:therapeutic use; D005290:Ferric Compounds / Q000009:adverse effects / Q000627:therapeutic use; D000077605:Ferric Oxide, Saccharated; D052203:Ferrosoferric Oxide / Q000009:adverse effects / Q000627:therapeutic use; D005937:Glucaric Acid / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D058085:Iron Compounds / Q000008:administration & dosage* / Q000009:adverse effects*; D007505:Iron-Dextran Complex / Q000009:adverse effects / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008320:Maltose / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D018384:Oxidative Stress / Q000187:drug effects / Q000502:physiology; D006435:Renal Dialysis
chemical_list: D004187:Disaccharides; D005290:Ferric Compounds; D058085:Iron Compounds; C021024:ferric hydroxide; C557707:iron isomaltoside 1000; C522335:ferric carboxymaltose; D008320:Maltose; D007505:Iron-Dextran Complex; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid; C035552:ferric gluconate; D052203:Ferrosoferric Oxide