Efficacy and safety of hight doses of parenteral iron in the treatment of ferropenic anemia in patients with cronic renal disease

Abstract

Objetive: to determine the efficacy and safety of iron saccharose at high doese (200 to 300 ml, intravenously) compared to the classical doses (100 mgr. I.V.) in patients with chronic renal disease and ferropenic anemia.

Design: descriptive Study

Setting: Renal Units of the Renal Therapy Servicie in Caldas (Santa Sofía Hospital and Hospital Infantil Rafael Henao Toro of the Red Cross.)

Patients: patients with chronic renal disease in stages 4 and 5, older than 18 years, with diagnosis of ferropenic anemia.

Methods: the efficacy of the management schemes was asses by means of observing the evolution of hemoglobin and ferritine variables as well as the transferrine saturation percentage, safety by looking at reactions to the medication for a period of six months. When the diagnosis of ferropenic anemia was confirmed and depending upon the dialysis treatment and the place where the patient lived (urban or rural area), the most appropriate dose for the patient was given intravenously. The doses used were 100, 200 and 300 mg. of saccharose iron at the following intervals: Post dialysis (3 times a weak), weakly of every two weeks, or every month.

Results: 1.267 doses of iron saccharose were given to 212 patients. The average changes of hemoglobin, ferritine and transferrine saturation % at the end of the study were 0.9 gm/dl, 255, 5 ng/ml and 1, 9 respectively. The most efficient treatment scheme was: to change hemoglobin and hematocrite value, 100 mg IV, with a mean hemoglobin elevation of 1.2 gm/dl (p=0, 0001), for transferrine saturation percentage 200 mg IV with a mean elevation of 313, 5 ng/ml (p=0, 0001): 7 patients had 13 events of minor adverse reactions: 5 reactions due to 100 mg doses, and 4 for each one the 200 and 300 mg doses. There were no deaths associated to the use of the medication

Conclusions: the high dose treatment schemes of 200 and 300 gr. Of saccharose iron were effective for the treatment of ferropenic anemia in patients with chronic renal disease. Well tolerated and had a low dose of adverse reactions, similar to those reported with the usual 100 mg doses.