Safety of intravenous iron use in chronic kidney disease
Open Access
- 1 November 2016
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Nephrology and Hypertension
- Vol. 25 (6), 529-535
- https://doi.org/10.1097/mnh.0000000000000263
Abstract
Iron deficiency anaemia (IDA) is common and associated with fatigue, reduced quality of life and poorer clinical outcomes. Treatment with oral iron is often inadequate and international guidelines recommend intravenous (i.v.) iron as the preferred option for the treatment of IDA in certain clinical situations. In this review, we assess the safety of using i.v. iron with a particular focus on patients with chronic kidney disease. Recent publications have raised safety concerns regarding the incidence of serious reactions accompanying i.v. infusion, as well as the subsequent risk of infections and cardiovascular events. Methodological flaws influence the interpretation of these data that lack evidence from the use of modern irons. The latter have been investigated in several randomized control trials. There is a need for better understanding and definition of the nature of i.v. iron reactions, as many are nonserious infusion reactions rather than true anaphylaxis. Retrospective identification of anaphylaxis is difficult and we suggest the importance of reanalysing data using fatalities or standardized terms as outcome measures. With the exception of high molecular weight iron dextran, serious or life-threatening reactions are rare with the use of i.v. irons, and they can be used safely for the treatment of IDA.Keywords
This publication has 44 references indexed in Scilit:
- The role of intravenous iron in the treatment of anemia in cancer patientsTherapeutic Advances in Hematology, 2012
- A comparative study of the physicochemical properties of iron isomaltoside 1000 (Monofer®), a new intravenous iron preparation and its clinical implicationsEuropean Journal of Pharmaceutics and Biopharmaceutics, 2011
- Ferric Carboxymaltose in Patients with Heart Failure and Iron DeficiencyThe New England Journal of Medicine, 2009
- Anemia, Diabetes, and Chronic Kidney DiseaseDiabetes Care, 2009
- Clinical update: intravenous iron for anaemiaThe Lancet, 2007
- Parenteral iron nephrotoxicity: Potential mechanisms and consequences1Kidney International, 2004
- Oxidative stress and renal injury with intravenous iron in patients with chronic kidney diseaseKidney International, 2004
- Safety in iron managementAmerican Journal of Kidney Diseases, 2003
- Adverse Events in Chronic Hemodialysis Patients Receiving Intravenous Iron Dextran – A Comparison of Two ProductsAmerican Journal of Nephrology, 2000
- Review of issues relating to iron and infectionAmerican Journal of Kidney Diseases, 1999