title: Correction of iron deficiency anaemia using IV CosmoFer in CKD patients with asthma: a prospective study.
abstract: BACKGROUND
  Intravenous (IV) iron is commonly used for correcting iron deficiency anaemia in patients with chronic kidney disease (CKD). There remains a concern for its use in patients with asthma as it may trigger an acute exacerbation. Pre-treatment with a single dose of parenteral hydrocortisone may obviate this risk.
  
  
  METHODS
  We carried out a prospective study of known asthmatic patients with CKD requiring single-dose iron repletion therapy. We analysed the efficacy and safety of IV CosmoFer (low molecular weight iron dextran). Twenty non-dialysis CKD patients with iron deficiency anaemia and a history of asthma were enrolled. Severity of asthma and level of control were recorded as per British Thoracic Society Guidelines and Royal Collage of Physician questionnaire, respectively. All patients received IV hydrocortisone 30 min before the test dose of CosmoFer followed by the remaining total dose. Patients were monitored for adverse reactions. Haemoglobin, serum ferritin levels and estimated glomerular filtration rate were measured pre and 6-weeks post-infusion. All patients were followed up until 6 weeks to assess the control of their asthma.
  
  
  RESULTS
  All 20 patients completed the study. No patient experienced acute hypersensitivity or infusion reactions. At 6 weeks follow-up, no patient reported worsening of their asthma. There was an increase in mean haemoglobin from 10.1 to 11.1 g/dl and mean ferritin from 93.5 to 302.6 ng/ml.
  
  
  CONCLUSIONS
  This study demonstrates that IV CosmoFer may be administered safely in asthmatics by administering a single 50 mg dose of hydrocortisone pre-infusion.
authors.affiliation: From the Department of Renal Medicine, Bradford Teaching Hospital NHS Foundation Trust, Duckworth lane, Bradford BD9 6RJ, UK and sunil.bhandari@hey.nhs.uk.
authors.forename: A
authors.initials: A
authors.lastname: Syed
authors.affiliation: Department of Renal Medicine, Hull and East Yorkshire Hospitals NHS Trust and Hull York Medical School, Anlaby Road, Kingston-upon-Hull HU3 2JZ, UK.
authors.forename: S
authors.initials: S
authors.lastname: Bhandari
mesh_terms: D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D001249:Asthma / Q000139:chemically induced* / Q000517:prevention & control; D004334:Drug Administration Schedule; D005260:Female; D005293:Ferritins / Q000097:blood; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007505:Iron-Dextran Complex / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; D007505:Iron-Dextran Complex; D005293:Ferritins; D006854:Hydrocortisone