TY - JOUR
T1 - Update on intravenous iron choices
AU - Larson, Derek S.
AU - Coyne, Daniel W.
PY - 2014/3/1
Y1 - 2014/3/1
N2 - Purpose of review Iron deficiency is a major factor in the prevalence and severity of anemia in patients with chronic kidney disease (CKD). We review the pathophysiology impairing normal intestinal iron absorption in CKD and compare the characteristics of newer intravenous (i.v.) iron agents to the longstanding i.v. iron products in the market. Recent findings The newer iron products, ferumoxytol, ferric carboxymaltose, and iron isomaltoside, more avidly bind iron, minimizing the release of labile iron during infusions, thus permitting large dose infusions. These irons also have more complex carbohydrate shells than their predecessors, which may also diminish reactions. Newer agents can be routinely administered at higher single doses, in as little as 15 min, with an acceptable safety profile. Summary Newer i.v. iron products permit the rapid, and sometimes complete, repletion of iron-deficient patients with a single dose. However, further studies examining the long-term risks and benefits of i.v. iron repletion are needed.
AB - Purpose of review Iron deficiency is a major factor in the prevalence and severity of anemia in patients with chronic kidney disease (CKD). We review the pathophysiology impairing normal intestinal iron absorption in CKD and compare the characteristics of newer intravenous (i.v.) iron agents to the longstanding i.v. iron products in the market. Recent findings The newer iron products, ferumoxytol, ferric carboxymaltose, and iron isomaltoside, more avidly bind iron, minimizing the release of labile iron during infusions, thus permitting large dose infusions. These irons also have more complex carbohydrate shells than their predecessors, which may also diminish reactions. Newer agents can be routinely administered at higher single doses, in as little as 15 min, with an acceptable safety profile. Summary Newer i.v. iron products permit the rapid, and sometimes complete, repletion of iron-deficient patients with a single dose. However, further studies examining the long-term risks and benefits of i.v. iron repletion are needed.
KW - Anaphylaxis
KW - Erythropoiesis
KW - Hepcidin
UR - http://www.scopus.com/inward/record.url?scp=84894074381&partnerID=8YFLogxK
U2 - 10.1097/01.mnh.0000441154.40072.2e
DO - 10.1097/01.mnh.0000441154.40072.2e
M3 - Review article
C2 - 24401789
AN - SCOPUS:84894074381
SN - 1062-4821
VL - 23
SP - 186
EP - 191
JO - Current Opinion in Nephrology and Hypertension
JF - Current Opinion in Nephrology and Hypertension
IS - 2
ER -