<--GAT-->

Intravenous Iron Replacement Creates More Safety Issues

by U.S. Medicine

August 16, 2017

INDIANAPOLIS—Anemia in chronic kidney disease is common, and iron deficiency is an important cause of anemia in chronic kidney disease, but what is the best way to replace the iron needed to repair it?

A study published in the journal Hemodialysis International made an effort to answer to that question.1

The study out of the Richard L. Roudebush VAMC and the Indiana University School of Medicine, both in Indianapolis, pointed out that iron can be replaced either by the oral route or by the intravenous route.

In a meta-analysis, five of six were short-term, one to three months, and compared to oral iron, the mean increase in hemoglobin with intravenous iron was only 0.31 g/dL. The report noted that one of the studies included in this meta-analysis was six months long, however, and had a mean decline in hemoglobin of 0.52 g/dL associated with intravenous iron administration.

“Given the short duration of most of the clinical trials comparing oral with intravenous administration of iron the long-term safety of these modes of administration of supplemental iron could not be assessed,” according to the study, which added that replacement of iron by the oral route is associated with mostly minor complications such as black stools, constipation and abdominal discomfort.

“In contrast, intravenous administration of iron may lead to severe adverse events such as anaphylaxis and, as a more recent randomized trial has suggested, delayed complications such as infections and cardiovascular disease,” the article stated.

The authors explained that delayed complications of repeated intravenous iron use are difficult to recognize at an individual level, suggesting, “inpatients who have had recent cardiovascular events or are infected, intravenous iron should probably be avoided.”

“Balancing safety and efficacy would require clinical judgment because one size may not fit all till we have better data to support the liberal use of parenteral iron,” the study concluded.

1 Agarwal R. Iron deficiency anemia in chronic kidney disease: Uncertainties and cautions. Hemodial Int. 2017 Jun;21 Suppl 1:S78-S82. doi: 10.1111/hdi.12561. Epub 2017 Apr 12. Review. PubMed PMID: 28403561.


Related Articles

VA Researcher Works to Find Improved Therapies for Esophageal Cancer

By Stephen Spotswood BALTIMORE—James Donahue, MD, has been thinking about the need for better treatments for cancer his entire adult life. His mother died from breast cancer when he was 14, and from that day... View Article

Is Aspirin Really a Wonder Drug for Cardiovascular Prevention?

VA Researcher Questions Daily Use of Drug in Many Patients By Brenda L. Mooney GAINESVILLE, FL—Since the mid-1980s, aspirin has been used as a preventive drug for cardiovascular disease. In fact, the U.S. Preventive Services... View Article


U.S. Medicine Recommends


More From august 2017

August 2017

VA Researcher Works to Find Improved Therapies for Esophageal Cancer

Master Sgt. Darryl Sterling, 332nd Expeditionary Logistics Readiness Squadron equipment manager, tosses unserviceable uniform items into a burn pit in Balad, Iraq, in 2008. (Photo by Senior Airman Julianne Showalter) WASHINGTON, DC — The potential... View Article

August 2017

Is Aspirin Really a Wonder Drug for Cardiovascular Prevention?

Master Sgt. Darryl Sterling, 332nd Expeditionary Logistics Readiness Squadron equipment manager, tosses unserviceable uniform items into a burn pit in Balad, Iraq, in 2008. (Photo by Senior Airman Julianne Showalter) WASHINGTON, DC — The potential... View Article

August 2017

Leukemia Often Is Preceded by Mediastinal Germ Cell Tumors

Master Sgt. Darryl Sterling, 332nd Expeditionary Logistics Readiness Squadron equipment manager, tosses unserviceable uniform items into a burn pit in Balad, Iraq, in 2008. (Photo by Senior Airman Julianne Showalter) WASHINGTON, DC — The potential... View Article

August 2017

Study Looks for Patterns in Lymphoma Relapse

Master Sgt. Darryl Sterling, 332nd Expeditionary Logistics Readiness Squadron equipment manager, tosses unserviceable uniform items into a burn pit in Balad, Iraq, in 2008. (Photo by Senior Airman Julianne Showalter) WASHINGTON, DC — The potential... View Article

August 2017

E-consults Drive Increased Involvement of VA Infectious Disease Specialists

Master Sgt. Darryl Sterling, 332nd Expeditionary Logistics Readiness Squadron equipment manager, tosses unserviceable uniform items into a burn pit in Balad, Iraq, in 2008. (Photo by Senior Airman Julianne Showalter) WASHINGTON, DC — The potential... View Article

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up