Atalay Huseyin, Solak Yalcin, Acar Kadir, Govec Nilgun, Turk Suleyman
Nephrology Department, Selcuk University, Meram School of Medicine, Meram, Konya, Turkey.
Hemodial Int. 2011 Jul;15(3):374-8. doi: 10.1111/j.1542-4758.2011.00550.x. Epub 2011 May 13.
Iron sucrose and low-molecular-weight iron dextran (LMW-ID), two commonly used iron solutions, have been compared in terms of allergic adverse event profiles to date. However, the safety of total dose infusion of LMW-ID has been investigated by only one study in chronic kidney disease (CKD) (not dialysis) patients. Thus, we aimed to compare adverse event profiles of total and high-dose LMW-ID and iron sucrose infusions in a heterogenous renal patient group comprising CKD, hemodialysis, and peritoneal dialysis. In this retrospective chart review study, we included 110 predialysis CKD, 101 peritoneal dialysis, and 118 hemodialysis patients. We included a total of 329 patients who were administered parenteral iron sucrose or LMW-ID between September 2006 and April 2010. Adverse events were determined both by medical and nursing follow-up notes. Laboratory data and clinical characteristics were collected from patient charts. Adverse event rates were compared between iron sucrose and LMW-ID infusions. In a total of 329 patients, 530 infusions (3470 ampules) were administered. We detected adverse reaction in only 1 patient. This adverse reaction, which manifested as generalized pruritus, occurred in a patient who received 500 mg of iron sucrose infusion. There were neither anaphylactic reactions nor deaths associated with infusion of either preparation. We did not observe any other adverse event related to administration of 500 and 1000 mg of iron sucrose at single infusion. The results of this study showed comparable safety of total dose LMW-ID and high-dose iron sucrose in a heterogenous group of renal patients.
到目前为止，已对两种常用的铁剂溶液——蔗糖铁和低分子右旋糖酐铁（LMW-ID）的过敏不良事件情况进行了比较。然而，仅一项针对慢性肾脏病（CKD）（非透析）患者的研究对LMW-ID全剂量输注的安全性进行了调查。因此，我们旨在比较LMW-ID全剂量和高剂量输注以及蔗糖铁输注在包括CKD、血液透析和腹膜透析患者在内的异质性肾病患者群体中的不良事件情况。在这项回顾性病历审查研究中，我们纳入了110例透析前CKD患者、101例腹膜透析患者和118例血液透析患者。我们总共纳入了2006年9月至2010年4月期间接受胃肠外蔗糖铁或LMW-ID治疗的329例患者。不良事件通过医疗和护理随访记录来确定。从患者病历中收集实验室数据和临床特征。比较了蔗糖铁和LMW-ID输注之间的不良事件发生率。在总共329例患者中，共进行了530次输注（3470支安瓿）。我们仅在1例患者中检测到不良反应。这种不良反应表现为全身性瘙痒，发生在接受500mg蔗糖铁输注的患者身上。两种制剂的输注均未发生过敏反应或死亡。我们未观察到与单次输注500mg和1000mg蔗糖铁相关的任何其他不良事件。这项研究的结果表明，在异质性肾病患者群体中，LMW-ID全剂量和高剂量蔗糖铁的安全性相当。
