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Adverse events associated with intravenous iron infusion low-molecular weight iron dextran and iron sucrose : a systematic review. Transfus Altern Transfus Med. Article Google Scholar. Moniem K, Bhandari S. Tolerability and efficacy of parenteral iron therapy in hemodialysis patients, a comparison of preparations. Download references. We are indebted to Pam Psutka, Pharmacist, for her role in initiating and implementing the project.
We also acknowledge the tireless work and excellent patient care provided by our IV therapy clinic nurses, Katrina Ormond and staff. Martha L. Louzada, Cyrus C. Hsia, Anargyros Xenocostas, Ian H. Connelly, Ian H. You can also search for this author in PubMed Google Scholar. Correspondence to Cyrus C. CCH designed the research, performed research, analyzed data, wrote and revised the paper.
LM helped perform research. AL-L and AX analyzed data and revised the paper. All authors read and approved the final manuscript. Reprints and Permissions. Louzada, M. Randomized double-blind safety comparison of intravenous iron dextran versus iron sucrose in an adult non-hemodialysis outpatient population: A feasibility study.
BMC Hematol 16, 7 Download citation. Received : 06 March Accepted : 08 March Published : 11 March Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.
Skip to main content. Search all BMC articles Search. Download PDF. Research article Open Access Published: 11 March Randomized double-blind safety comparison of intravenous iron dextran versus iron sucrose in an adult non-hemodialysis outpatient population: A feasibility study Martha L.
Louzada 1 , 2 , Cyrus C. Connelly 2 , 4 , Ian H. Abstract Background Intravenous iron therapy is a treatment option for iron deficient patients who are intolerant to oral iron or where oral iron is ineffective, but with possible adverse effects. Results We enrolled patients in a one-year period. Conclusion In this limited feasibility study, no major differences in immediate reactions were seen, but a significantly higher number of delayed reactions were seen in the iron sucrose group.
Study design and sample size The primary objective of this study was to assess the feasibility and to inform details for the design of a future randomized controlled trial to be conducted at our centre comparing the safety of equal doses of intravenous iron dextran or iron sucrose in non-hemodialysis adult patients. Study outcomes The primary feasibility outcome of the study was enrollment of at least patients per year.
Intravenous IV iron is an alternative treatment for patients intolerant or non-responsive to oral formulations. Of the two most common formulations available in Canada, IV iron dextran is less expensive but may be associated with more overall ADRs compared to IV iron sucrose.
The incidence of immediate during outpatient hospital visit and delayed within 24 hours after patient discharged ADRs for each iron formulation were compared. Baseline characteristics of participants were analyzed by means of descriptive statistics. Demographic and clinical characteristics of study participants were evaluated by adverse reaction status.
They were compared using a two-sample t-test for continuous variables and a two-way contingency table using Chi square or Fisher's exact test for categorical variables, as appropriate.
Patients were contacted 24 hours after discharge to answer a standardized questionnaire. Grading of severity was done independently by three individuals from an independent Drug Safety Monitoring Board. Baseline characteristics of patients is depicted in Table 1. All patients received IV iron 73 iron dextran and 70 iron sucrose and none were lost to follow-up.
The average additional nursing time required to manage immediate ADRs was approximately 30 minutes. Details in Table 2. Four patients were considered to have serious adverse reactions shortness of breath, bronchospasm and diaphoresis. Two form each study arm. A RCT to compare adverse drug reaction rates between iron dextran and iron sucrose in non-hemodialysis adult patients with iron deficiency anemia is feasible. The design of the study with a one point in time evaluation and a short follow up that did not require extra hospital visits and blood tests were probably attractive features that maximized patient participation.
However, a striking higher rate of delayed ADRs, albeit not severe, was slightly more pronounced in patients receiving iron sucrose therapy. American Regent Laboratories, Inc. Lawrence R: Development and comparison of iron dextran products. Article Google Scholar. An in vivo study.
Clin Drug Invest. In: Core curriculum for the dialysis technician. Amgen Inc. Thousand Oaks, CA, 2. Perit Dial Int. J Amer Soc Nephrol. Google Scholar. Download references. McClaran, RN for their assistance in this project. This study was supported by an unrestricted research grant from American Regent, Inc. You can also search for this author in PubMed Google Scholar. Correspondence to Harold J Manley. The authors received funding for this study by American Regent, Inc.
The authors have no other competing interests. Reprints and Permissions. Manley, H. Determination of iron sucrose Venofer or iron dextran DexFerrum removal by hemodialysis: an in-vitro study.
BMC Nephrol 5, 1 Download citation. Received : 31 March Accepted : 12 January Published : 12 January Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background Intravenous iron is typically administered during the hemodialysis HD procedure.
Methods Two in vitro HD systems were designed and constructed to determine the dialyzabiltiy of iron from a simulated blood system SBS containing mg iron sucrose or iron dextran system A or mg iron sucrose system B. Results The greatest percentage removal from the SBS was Conclusion HF or HE dialysis membranes do not remove clinically significant amounts of iron sucrose or dextran formulations over a 4-hour HD session.
Background Iron deficiency is a common problem in hemodialysis HD patients [ 1 ]. Control for potential iron contamination Disposable supplies e. Samples analysis The determination of iron concentration in study samples was performed using atomic absorption spectrophotometry. In vitro system A Prior to analysis samples were prepared by pipetting 2. A monoexponential model was assumed and pharmacokinetic parameters were calculated using the following formulae: 1.
Elimination rate constant for HD period K hd was calculated:. Results In vitro system A Instillation of iron sucrose or iron dextran into the SBS resulted in a light brown colored solution.
Table 1 Iron sucrose removal by high-flux or high-efficiency hemodialysis membranes over minutes. System A Full size table. Table 2 Iron dextran removal by high-flux or high-efficiency hemodialysis membranes over minutes.
Table 3 Iron sucrose removal in a closed-loop system by high-flux or high-efficiency hemodialysis membranes over minutes. System B Full size table. Discussion Intravenous iron is frequently given to HD patients to treat or prevent iron deficiency anemia[ 1 ]. HJM performed the statistical analysis. References 1. CAS Google Scholar 3. Article Google Scholar 7. Thousand Oaks, CA, 2 View author publications.
Additional information Competing interests The authors received funding for this study by American Regent, Inc. Rights and permissions Reprints and Permissions. About this article Cite this article Manley, H. Copy to clipboard.
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