title: Update on intravenous iron choices.
abstract: OBJECTIVE
  Iron deficiency is a major factor in the prevalence and severity of anemia in patients with chronic kidney disease (CKD). We review the pathophysiology impairing normal intestinal iron absorption in CKD and compare the characteristics of newer intravenous (i.v.) iron agents to the longstanding i.v. iron products in the market.
  
  
  RESULTS
  The newer iron products, ferumoxytol, ferric carboxymaltose, and iron isomaltoside, more avidly bind iron, minimizing the release of labile iron during infusions, thus permitting large dose infusions. These irons also have more complex carbohydrate shells than their predecessors, which may also diminish reactions. Newer agents can be routinely administered at higher single doses, in as little as 15 min, with an acceptable safety profile.
  
  
  CONCLUSIONS
  Newer i.v. iron products permit the rapid, and sometimes complete, repletion of iron-deficient patients with a single dose. However, further studies examining the long-term risks and benefits of i.v. iron repletion are needed.
authors.affiliation: Renal Division, Washington University, St. Louis, Missouri, USA.
authors.forename: Derek S
authors.initials: DS
authors.lastname: Larson
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Coyne
mesh_terms: D061605:Administration, Intravenous; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004187:Disaccharides / Q000008:administration & dosage; D005290:Ferric Compounds / Q000008:administration & dosage; D052203:Ferrosoferric Oxide / Q000008:administration & dosage; D006397:Hematinics / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D006706:Homeostasis; D006801:Humans; D007408:Intestinal Absorption; D008320:Maltose / Q000008:administration & dosage / Q000031:analogs & derivatives; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D004187:Disaccharides; D005290:Ferric Compounds; D006397:Hematinics; C557707:iron isomaltoside 1000; C522335:ferric carboxymaltose; D008320:Maltose; D052203:Ferrosoferric Oxide