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[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.
AuthorsS A Potthoff, H G Münch
JournalDeutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 138 Issue 24 Pg. 1312-7 (Jun 2013) ISSN: 1439-4413 [Electronic] Germany
Vernacular TitleSicherheitsaspekte parenteraler Eisentherapien bei Patienten mit chronischer Niereninsuffizienz.
PMID23737117 (Publication Type: Comparative Study, Journal Article, Review)
Copyright© Georg Thieme Verlag KG Stuttgart · New York.
Chemical References
  • Disaccharides
  • Ferric Compounds
  • Iron Compounds
  • ferric hydroxide
  • iron isomaltoside 1000
  • ferric carboxymaltose
  • Maltose
  • Iron-Dextran Complex
  • Ferric Oxide, Saccharated
  • Glucaric Acid
  • ferric gluconate
  • Ferrosoferric Oxide
Topics
  • Administration, Oral
  • Anaphylaxis (chemically induced)
  • Anemia, Iron-Deficiency (drug therapy)
  • Disaccharides (adverse effects, therapeutic use)
  • Ferric Compounds (adverse effects, therapeutic use)
  • Ferric Oxide, Saccharated
  • Ferrosoferric Oxide (adverse effects, therapeutic use)
  • Glucaric Acid (adverse effects, therapeutic use)
  • Humans
  • Infusions, Intravenous
  • Iron Compounds (administration & dosage, adverse effects)
  • Iron-Dextran Complex (adverse effects, therapeutic use)
  • Kidney Failure, Chronic (complications, therapy)
  • Maltose (adverse effects, analogs & derivatives, therapeutic use)
  • Oxidative Stress (drug effects, physiology)
  • Renal Dialysis

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