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Titolo:
A prospective crossover trial comparing intermittent intravenous and continuous oral iron supplements in peritoneal dialysis patients
Autore:
Johnson, DW; Herzig, KA; Gissane, R; Campbell, SB; Hawley, CM; Isbel, NM;
Indirizzi:
Princess Alexandra Hosp, Dept Renal Med, Brisbane, Qld 4102, Australia Princess Alexandra Hosp Brisbane Qld Australia 4102 , Qld 4102, Australia
Titolo Testata:
NEPHROLOGY DIALYSIS TRANSPLANTATION
fascicolo: 9, volume: 16, anno: 2001,
pagine: 1879 - 1884
SICI:
0931-0509(200109)16:9<1879:APCTCI>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
RECOMBINANT-HUMAN-ERYTHROPOIETIN; HEMODIALYSIS-PATIENTS; ANEMIA; DEXTRAN;
Keywords:
erythropoietin; ferritin; haemoglobins; iron economics; peritoneal dialysis; prospective studies;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Johnson, DW Princess Alexandra Hosp, Dept Renal Med, Level 2,Ambulatory Renal & Transplant Serv Bldg,I, Brisbane, Qld 4102, Australia Princess Alexandra Hosp Level 2,Ambulatory Renal & Transplant Serv Bldg,I Brisbane Qld Australia 4102
Citazione:
D.W. Johnson et al., "A prospective crossover trial comparing intermittent intravenous and continuous oral iron supplements in peritoneal dialysis patients", NEPH DIAL T, 16(9), 2001, pp. 1879-1884

Abstract

Background. Concomitant iron supplementation is required in the great majority of erythropoietin (Epo)-treated patients with end-stage renal failure. Intravenous (i.v.) iron supplementation has been demonstrated to be superior to oral iron therapy in Epo-treated haemodialysis patients, but comparative data in iron-replete peritoneal dialysis (PD) patients are lacking. Methods. A 12-month, prospective, crossover trial comparing oral and i.v. iron supplementation was conducted in all Princess Alexandra Hospital PD patients who were on a stable dose of Epo, had no identifiable cause of impaired haemopoiesis other than uraemia, and had normal iron stores (transferrin saturation > 20% and serum ferritin 100-500 mg/l). Patients received daily oral iron supplements (210 mg elemental iron per day) for 4 months followed by intermittent, outpatient i.v. iron infusions (200 mg every 2 months) for 4 months, followed by a further 4 months of oral iron. Haemoglobin levels and body iron stores were measured monthly. Results. Twenty-eight individuals were entered into the study and 16 patients completed 12 months of follow-up. Using repeated-measures analysis of variance, haemoglobin concentrations increased significantly during the i.v.phase (108 +/-3 to 114 +/-3 g/l) compared with each of the oral phases (109 +/-3 to 108 +/-3 g/l and 114 +/-3 to 107 +/-4 g/l, P <0.05). Similar patterns were seen for both percentage transferrin saturation (23.8 +/-2.3 to 30.8 +/-3.0%, 24.8 +/-2.1 to 23.8 +/-2.3%, and 30.8 +/-3.0 to 26.8 +/-2.1%, respectively, P <0.05) and ferritin (385 +/- 47 to 544 +/- 103 mg/l, 317 +/- 46 to 385 +/- 47 mg/l, 544 +/- 103 to 463 +/- 50 mg/l, respectively, P=0.10). No significant changes in Epo dosages were observed throughout the study. I.v. iron supplementation was associated with a much lower incidence ofgastrointestinal disturbances (11 vs 46%, P <0.05), but exceeded the cost of oral iron treatment by 6.5-fold. Conclusions. Two-monthly i.v. iron infusions represent a practical alternative to oral iron and can be safely administered to PD patients in an outpatient setting. Compared with daily oral therapy, 2-monthly i.v. iron supplementation in PD patients was better tolerated and resulted in superior haemoglobin levels and body iron stores.

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Documento generato il 21/09/20 alle ore 10:36:35