title: [Clinical experience with ferric carboxymaltose in non-dialysis chronic kidney disease].
abstract: BACKGROUND
  Patients with non-dialysis-dependent chronic kidney disease (ND-CKD) often show anemia and iron deficiency despite oral iron supplementation caused by poor iron absorption, intolerance and non-compliance.
  
  
  METHODS
  We prospectively followed seven adult patients with ND-CKD (eGFR <60 ml/min/1.73m2), anemia (Hb<11 g/dl or treatment with ESA), iron deficiency (TSAT<20% and/or ferritin<100 ng/mL) and intolerant or non-responders to oral iron supplementation. Patients received ferric carboxymaltose (FCM) (single dose of 500 mg iv) eventually followed by further doses if iron deficiency persisted. Hemoglobin, ferritin, TSAT and ESA doses were recorded at baseline and after 2, 4, 8, 12, 16, 20 and 24 weeks.
  
  
  RESULTS
  After 2 weeks of FCM, ferritin increased from 5348 to 222154 ng/mL (P<0.05) and remained steady thereafter. The increase of TSAT from baseline (115%) was more gradual being significant from week 4 (198%) up to week 24 (2412%). During the study, patients received on average 2.31.0 injections of FCM, to the amount of 1143440 mg. Hb levels remained stable throughout the study, despite a significant reduction of ESA dosage (from 3426 g/week at baseline to 1116 and 1710 g/week, after 4 and 24 weeks, respectively). On average, the ESA dose saving was 2024 g/week. Even considering the higher cost of FCM, ESA dose reduction allowed shortening overall costs by 673/patient during the 24 weeks of study.
  
  
  CONCLUSIONS
  In ND-CKD patients, FCM is effective in correcting iron deficiency and associated with stable Hb levels and significant decrease of ESA dosage. This allows a marked reduction of costs for anemia correction.
authors.forename: Roberto
authors.initials: R
authors.lastname: Minutolo
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Liberti
authors.forename: Carlo
authors.initials: C
authors.lastname: Garofalo
authors.forename: Mario
authors.initials: M
authors.lastname: Pacilio
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sagliocchi
authors.forename: Azzurra
authors.initials: A
authors.lastname: Sguazzo
authors.forename: Luisa
authors.initials: L
authors.lastname: Scarpati
authors.forename: Adelia
authors.initials: A
authors.lastname: Sagliocca
authors.forename: Sara
authors.initials: S
authors.lastname: Santangelo
authors.forename: Michele
authors.initials: M
authors.lastname: Provenzano
authors.forename: Manuela
authors.initials: M
authors.lastname: Savino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Conte
authors.forename: Luca
authors.initials: L
authors.lastname: De Nicola
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005290:Ferric Compounds / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008320:Maltose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications
chemical_list: D005290:Ferric Compounds; C522335:ferric carboxymaltose; D008320:Maltose