Efficacy and safety of a low monthly dose of intravenous iron sucrose in peritoneal dialysis patients

Mitsopoulos, Efstathios; Lysitska, Aikaterini; Pateinakis, Panagiotis; Lamprou, Vasileios; Intzevidou, Eleni; Minasidis, Ilias; Katsaounou, Chrysa; Kougioumtzidou, Ourania; Anagnostou, Nikolaos; Lemonidis, Nikolaos; Papadopoulou, Dorothea

doi:10.1007/s11255-019-02362-4

Cited by 11 publications

(10 citation statements)

References 19 publications

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“…In a recent small observational study, 15 PD patients receiving 400-700 mg of IV iron sucrose in divided doses showed an increase of mean Hb level (from 10.0 to 10.9 mg/dL, p = 0.01), mean ferritin (from 143 to 260 ng/mL. p = 0.005) and TSAT (from 26.2 to 33.1%, p = 0.07) [29]. They also reported a significant 23% reduction of ESA doses.…”

Section: Discussionmentioning

confidence: 93%

Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study

Minutolo

Berto²,

Liberti

et al. 2021

JCM

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No information is available on the efficacy of ferric carboxymaltose (FCM) in real-world CKD patients outside the hemodialysis setting. We prospectively followed 59 non-hemodialysis CKD patients with iron deficient anemia (IDA: hemoglobin <12.0/<13.5 g/dL in women/men and TSAT < 20% and/or ferritin < 100 ng/mL) who were intolerant or non-responders to oral iron. Patients received ferric carboxymaltose (FCM) (single dose of 500 mg) followed by additional doses if iron deficiency persisted. We evaluated efficacy of FCM in terms of increase of hemoglobin, ferritin, and TSAT levels. Direct and indirect costs of FCM were also analyzed in comparison with a hypothetical scenario where same amount of iron as ferric gluconate (FG) was administered intravenously. During the 24 weeks of study, 847 ± 428 mg of FCM per patient were administered. IDA improved after four weeks of FCM and remained stable thereafter. At week-24, mean change (95%CI) from baseline of hemoglobin, ferritin and TSAT were +1.16 g/dL (0.55–1.77), +104 ng/mL (40–168) and +9.5% (5.8–13.2), respectively. These changes were independent from ESA use and clinical setting (non-dialysis CKD, peritoneal dialysis and kidney transplant). Among ESA-treated patients (n = 24), ESA doses significantly decreased by 26% with treatment and stopped either temporarily or persistently in nine patients. FCM, compared to a FG-based scenario, was associated with a cost saving of 288 euros/patient/24 weeks. Saving was the same in ESA users/non-users. Therefore, in non-hemodialysis CKD patients, FCM effectively corrects IDA and allows remarkable cost savings in terms of societal, healthcare and patient perspective.

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Section: Discussionmentioning

confidence: 93%

Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study

Minutolo

Berto²,

Liberti

et al. 2021

JCM

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“…The results of the aforementioned study are consistent with the findings of the current study, probably due to the short duration of the treatment. In 2020, a study was carried out by Mitsopoulos et al in Greece in which during 12 weeks of the IV administration of erythropoietin, the Hb levels increased from 10 to 10.9, which was statistically significant (23). However, these patients also received iron during their treatment.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of effect of synthetic erythropoietin on hemoglobin in dialysis patients

et al. 2021

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Introduction: Anemia is a common complication of chronic kidney disease (CKD) due to the insufficient production of erythropoietin by the kidneys. The administration of erythropoietin is one of the most common methods for the treatment of patients with anemia. Objectives: This study aimed to investigate the effect of the administration of synthetic erythropoietin on hemoglobin levels in dialysis patients using a systematic review and meta-analysis. Methods: In order to identify the related studies, the international databases of Web of Science, PubMed, Scopus, and Embase were searched from 2015 to 2020 using standard and valid keywords. The data were analyzed using STATA software (version 14), and a p-value of less than 0.05 was considered statistically significant. Results: In 12 reviewed articles with a sample size of 4,060 individuals, the standard effect size of the effect of synthetic erythropoietin on Hb in dialysis patients was reported as 2.08 (95% CI: 1.53-2.63), which was statistically significant; however, erythropoietin biosimilars did not show similar results. Conclusion: The administration of erythropoietin to hemodialysis patients increases Hb levels by more than 2 units.

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“…Iron deficiency is a common observation in this population given the lack of easy vascular access and the low efficacy of oral iron. More sustained IV iron administration could be a therapeutic option to be implemented [ 77 ].…”

Section: The Physiology Of Iron Metabolismmentioning

confidence: 99%

Intravenous iron therapy and the cardiovascular system: risks and benefits

Vecchio

Ekart

Ferro

et al. 2020

Clinical Kidney Journal

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Anaemia is a common complication of chronic kidney disease (CKD). In this setting, iron deficiency is frequent because of the combination of increased iron needs to sustain erythropoiesis with increased iron losses. Over the years, evidence has accumulated on the involvement of iron in influencing pulmonary vascular resistance, endothelial function, atherosclerosis progression and infection risk. For decades, iron therapy has been the mainstay of therapy for renal anaemia together with erythropoiesis-stimulating agents (ESAs). Despite its long-standing use, grey areas still surround the use of iron therapy in CKD. In particular, the right balance between either iron repletion with adequate therapy and the avoidance of iron overload and its possible negative effects is still a matter of debate. This is particularly true in patients having functional iron deficiency. The recent Proactive IV Iron Therapy in Haemodialysis Patients trial supports the use of intravenous (IV) iron therapy until a ferritin upper limit of 700 ng/mL is reached in haemodialysis patients on ESA therapy, with short dialysis vintage and minimal signs of inflammation. IV iron therapy has also been proven to be effective in the setting of heart failure (HF), where it improves exercise capacity and quality of life and possibly reduces the risk of HF hospitalizations and cardiovascular deaths. In this review we discuss the risks of functional iron deficiency and the possible benefits and risks of iron therapy for the cardiovascular system in the light of old and new evidence.

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Efficacy and safety of a low monthly dose of intravenous iron sucrose in peritoneal dialysis patients

Cited by 11 publications

References 19 publications

Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study

Ferric Carboxymatose in Non-Hemodialysis CKD Patients: A Longitudinal Cohort Study

A systematic review and meta-analysis of effect of synthetic erythropoietin on hemoglobin in dialysis patients

Intravenous iron therapy and the cardiovascular system: risks and benefits

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