Regular low-dose intravenous iron therapy improves response to erythropoietin in haemodialysis patients

Taylor, J. E.; Peat, Nicola; Porter, Christine J.; Morgan, A. G.

doi:10.1093/ndt/11.6.1079

Cited by 74 publications

(45 citation statements)

References 4 publications

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“…Several attempts to maintain the hematocrit value by administering iron preparations and to decrease the consumption volume of erythropoietin preparations have been made from the pharmacoeconomic viewpoint in U.S.A. and Europe. [8][9][10] Most recently, even in Japan, a physicians' research group has reported that a small dose of iron preparations resulted in a 30% reduction of erythropoietin consumption for one year in Japan.…”

Section: Discussionmentioning

confidence: 99%

Impact of a Pharmacist-Implemented Anemia Management in Outpatients with End-Stage Renal Disease in Japan

Kimura

Arai

Masuda

et al. 2004

Biological & Pharmaceutical Bulletin

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Section: Discussionmentioning

confidence: 99%

Impact of a Pharmacist-Implemented Anemia Management in Outpatients with End-Stage Renal Disease in Japan

Kimura

Arai

Masuda

et al. 2004

Biological & Pharmaceutical Bulletin

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“…The number of sideroblasts, nucleated erythrocyte precursors that stain for iron with Prussian blue, is decreased in AI 12, again suggesting iron restriction. As a further indication of the limiting role of iron in patients with AI but no evidence of iron deficiency, the resistance of AI to erythropoietin therapy can sometimes be overcome by the co-administration of parenteral iron 17,18. The mechanism by which high doses of intravenous iron preparations ameliorate resistance to pharmacologic doses of erythropoietin19, even in situations where ferritin is elevated20,21, is not yet clear.…”

Section: Iron Restriction Is a Major Contributor To Anemia Of Inflammmentioning

confidence: 99%

Iron Sequestration and Anemia of Inflammation

Ganz

Nemeth

2009

Seminars in Hematology

306

229

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Anemia of chronic disease, also called anemia of inflammation, is characterized by hypoferremia due to iron sequestration that eventually results in iron-restricted erythropoiesis. During the last decade, the molecular mechanisms of iron sequestration have been found to center on cytokinestimulated overproduction of the iron-regulatory hormone hepcidin. The inflammatory cytokine IL-6 is a particularly prominent inducer of hepcidin but other cytokines are likely to contribute as well. Hepcidin excess causes the endocytosis and proteolysis of the sole known cellular iron exporter, ferroportin, trapping iron in macrophages and iron-absorbing enterocytes. The supply of iron to hemoglobin synthesis becomes limiting, eventually resulting in anemia. Depending on the details of the underlying disease, other inflammation-related mechanisms may also contribute to anemia. Hypoferremia in infection and inflammationAs described more than sixty years ago, serum iron concentrations markedly decrease in humans 1 and in dogs 2 during the first few days of systemic infection or inflammation. More recent experimental studies in human volunteers injected with moderate doses of lipopolysaccharide 3 showed approximately a 50% decrease in serum iron by 24 hours. In another group of human subjects, a 3hr infusion of interleukin 6 (IL-6) was followed by an average 30% drop in serum iron 2 hrs later 4 . The rapid development of hypoferremia was also observed in mice with experimental meningococcal infection 5 or inflammation induced by turpentine 6 or LPS 7 . As suggested by the deleterious effects of iron supplementation during experimental infections 8,9 , the hypoferremia probably contributes to host defense against infection, likely by decreasing the iron supply to invading microbes. Hypoferremia of inflammation is caused by iron sequestration in macrophagesAs discussed elsewhere in this issue, normally most of the iron delivered to plasma (about 20-25 mg/day) is provided by macrophages involved in recycling senescent erythrocytes, and only 1-2 mg/day comes from iron absorption in the duodenum, with additional variable amounts delivered from stored iron in hepatocytes. Studies with iron-radiolabeled damaged erythrocytesCorrespondence to: Tomas Ganz, PhD, MD, CHS 37-055, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1690, Tel. 310-825-6112, FAX 310-206-8766, E-mail: tganz@mednet.ucla.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. documented that inflammation or infection led to delayed appearance of radioactive iron in circulation and the a...

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“…Intravenous iron supplementation is superior to oral iron in the maintenance of iron stores during EPO therapy [28][29][30]. The effectiveness of oral iron is limited by patient non-compliance, gastrointestinal side-effects and interaction with other oral medication.…”

Section: Discussionmentioning

confidence: 99%

Administration of the same dose of epoetin-beta intravenously and subcutaneously to patients with renal anaemia

Steffensen

Stergaard

2011

Scandinavian Journal of Urology and Nephrology

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Regular low-dose intravenous iron therapy improves response to erythropoietin in haemodialysis patients

Abstract: Regular intravenous iron supplementation in haemodialysis patients improves the response to Epo therapy.

Cited by 74 publications

References 4 publications

Impact of a Pharmacist-Implemented Anemia Management in Outpatients with End-Stage Renal Disease in Japan

Impact of a Pharmacist-Implemented Anemia Management in Outpatients with End-Stage Renal Disease in Japan

Iron Sequestration and Anemia of Inflammation

Administration of the same dose of epoetin-beta intravenously and subcutaneously to patients with renal anaemia

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