Loss of Iron-Dextran through Cuprophane Membrane of a Disposable Coil Dialyser

Manuel, Machelle; Stewart, W. K.; Neill, G D St Clair; Hutchinson, Fiona J.

doi:10.1159/000180138

Cited by 11 publications

(6 citation statements)

References 10 publications

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“…Our results are consistent to previous in-vitro and in-vivo reports [6-8]. In a 30-minute HD in-vitro study iron dextran removal was determined for HF and HE dialyzers [7].…”

Section: Discussionsupporting

confidence: 91%

“…The greatest amount of iron removed (8%) was observed with a F8 (Fresenius) HF dialyzer [7]. Other investigators utilizing a cuprophane coil dialyzer in-vitro system determined a 0.5% iron dextran removal over 240 minutes [6]. The only in-vivo dialyzability study utilized iron dextran and HE membranes (Terumo 165 cuprammonium dialyzer) [8].…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports have shown that very little iron dextran (InFed ® , Watson Pharmaceuticals, molecular weight 90,000 daltons [5]) is removed via HD [6-8]. However it is unknown to what extent the HD procedure removes the other iron dextran product (DexFerrum ® , American Regent, Inc., molecular weight 265,000 daltons [5]) or iron sucrose (Venofer ® , American Regent, Inc., molecular weight 34,000 – 60,000 daltons [4]).…”

Section: Introductionmentioning

confidence: 99%

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Determination of iron sucrose (Venofer) or iron dextran (DexFerrum) removal by hemodialysis: an in-vitrostudy

Manley

Grabe

2004

BMC Nephrol

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BackgroundIntravenous iron is typically administered during the hemodialysis (HD) procedure. HD patients may be prescribed high-flux (HF) or high-efficiency (HE) dialysis membranes. The extent of iron sucrose and iron dextran removal by HD using HF or HE membranes and by ultrafiltration rate (UFR) is unknown.MethodsTwo in vitro HD systems were designed and constructed to determine the dialyzabiltiy of iron from a simulated blood system (SBS) containing 100 mg iron sucrose or iron dextran (system A) or 1000 mg iron sucrose (system B). Both in vitro systems utilized a 6-L closed-loop SBS system that was subject to 4 different HD conditions conducted over 4 hours: HE membrane + 0 ml/hr UFR; HE membrane + 500 ml/hr UFR; HF membrane + 0 ml/hr UFR; HF membrane + 500 ml/hr UFR. Blood flow and dialysate flow rates were 500 ml/min and 800 ml/min, respectively. The dialysate compartment was a 192-L open system for system A and a 6-L closed-loop system for system B. Samples from the SBS and dialysate compartments were taken at various time points and iron elimination rate and HD clearance was determined. Iron removal from the SBS > 15% was considered clinically significant.ResultsThe greatest percentage removal from the SBS was 13.5% and -0.03% utilizing system A and B, respectively. Iron sucrose and iron dextran dialysate concentration was below the lower limits of assay (< 2 ppm) for system A. Dialysate recovery of iron was negligible: 0 – 5.4 mg system A and 5.47 – 23.59 mg for system B. Dialyzer type or UFR did not affect iron removal.ConclusionHF or HE dialysis membranes do not remove clinically significant amounts of iron sucrose or dextran formulations over a 4-hour HD session. This effect remained constant even controlling for UFR up to 500 ml/hour. Therefore, iron sucrose and iron dextran are not dialyzed by HE or HF dialysis membranes irrespective of UFR.

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“…Our results are consistent to previous in-vitro and in-vivo reports [6-8]. In a 30-minute HD in-vitro study iron dextran removal was determined for HF and HE dialyzers [7].…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Determination of iron sucrose (Venofer) or iron dextran (DexFerrum) removal by hemodialysis: an in-vitrostudy

Manley

Grabe

2004

BMC Nephrol

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“…There have been two in vitro and one in vivo study that describe the removal of iron dextran by hemodialysis. The first in vitro study showed that less than 0.5% of a 50 mg iron dextran dosage was removed during hemodialysis 7 . The other in vitro study showed that the maximum amount of iron dextran removed by hemodialysis was about 8% when a polysulfone F8 dialyzer was used 8 .…”

Section: Discussionmentioning

confidence: 99%

Removal of iron dextran (Cosmofer®) during hemodialysis

Chen

Wang

2008

Transfus Alt Transfus Med

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SUMMARY Intravenous iron dextran is widely used in hemodialysis patients receiving erythropoietin (EPO) therapy because of its significant convenience in clinical practice. However, the amount of iron removed by hemodialysis in vivo is unknown. The purpose of this study was to measure the removal of iron dextran in patients undergoing hemodialysis. Six patients were enrolled in this study. All were stable patients treated by hemodialysis for at least 1 month. Both F6 (polysulphone membrane) and GFSplus12 (hemophane membrane) dialyzers were used sequentially in each patient. Each patient received 2 mL of low‐molecular‐weight iron dextran (Cosmofer® aktieselskab/aksjeselskap and supplied by Zhuhai Schwarz Pharma Company Ltd) intravenously, containing 100 mg of elemental iron, administered during the second hour of dialysis over 30 to 60 minutes. A baseline sample of fresh dialysate was collected before the commencement of dialysis. A control sample of spent dialysate was collected during the first hour of dialysis, before the infusion of low‐molecular‐weight iron dextran. Then, all spent dialysate after the iron dextran infusion until the end of dialysis was collected. The samples were treated with lanthanum nitrate solution, and the iron content was measured using an atomic‐absorptive spectrum method. The iron concentration in the control group was 4.31 ± 2.55 µg/L. After the infusion of iron dextran, the iron concentration in the spent dialysate increased significantly, irrespective of whether an F6 or GFSplus12 dialyzer was used. However, the amount of iron eliminated through the dialyzer was minimal, less than 3% of the infusion dose. There was no significant difference in removal of iron through either the F6 or GFSplus12 dialyzer. These results indicate that the removal of iron dextran by hemodialysis when using either a polysulfphone or hemophane membrane dialyzer is negligible. It is time‐efficient and convenient to administer low‐molecular‐weight iron dextran during hemodialysis.

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“…On the contrary, no dialyzable iron was found in in vitro experiments within iron saccharate [12] and iron dextran (DexFerrum ® , American Regent) [12]. Other studies have detected less than 0.5% and sometimes up to 8% dialyzable iron in iron dextran (Imferon InFeD ® , respectively) [13,14].…”

Section: Introductionmentioning

confidence: 98%

CE characterization of potential toxic labile iron in colloidal parenteral iron formulations using off‐capillary and on‐capillary complexation with EDTA

et al. 2007

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The present study describes the application of CZE to investigate the portion of labile iron in the following parenteral formulations: iron gluconate, iron saccharate, and iron dextran. Labile iron was detected as Fe(III)-chelate of EDTA at 246 nm. When EDTA was incubated with the formulations before electrophoresis, labile iron, or chelatable iron, respectively, was detected in all formulations, mostly in iron gluconate and iron saccharate. It was observed that the amount of iron released is time- and pH-dependent. In contrast, when EDTA was separately injected before the formulation sharp peaks of the Fe(III)-chelate were detected only after injection of iron gluconate. This type of labile iron can be described as "electrophoretically free" iron. CE provides thus a new method to characterize potential toxic, labile iron in parenteral iron formulations.

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Loss of Iron-Dextran through Cuprophane Membrane of a Disposable Coil Dialyser

Abstract: An in vitro study has demonstrated that pharmaceutical iron-dextran (Imferon) does not pass through, nor is it adsorbed on to, the cuprophane membranes (PT 150) of a disposable coil haemodialyser.

Cited by 11 publications

References 10 publications

Determination of iron sucrose (Venofer) or iron dextran (DexFerrum) removal by hemodialysis: an in-vitrostudy

Determination of iron sucrose (Venofer) or iron dextran (DexFerrum) removal by hemodialysis: an in-vitrostudy

Removal of iron dextran (Cosmofer®) during hemodialysis

CE characterization of potential toxic labile iron in colloidal parenteral iron formulations using off‐capillary and on‐capillary complexation with EDTA

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