Department of Neprology and Hypertension, Rabin Medical Center, Petah Tikva, Israel.
Clin Transplant. 2012 Jul-Aug;26(4):608-14. doi: 10.1111/j.1399-0012.2012.01602.x. Epub 2012 Mar 8.
We sought to evaluate the effect of intravenous (IV) iron supplementation on hemoglobin (Hb) levels and detect predictors for response.
This is a retrospective cohort study of 81 patients who were treated with IV iron post-transplant. We evaluated predictors of response to treatment defined as an increase in Hb value of more than 1 g/dL by linear regression analysis.
Three months after treatment, the mean Hb level increased significantly from 9.8 ± 1.4 g/dL to 11.1 ± 1.6 g/dL (p < 0.001). A lower baseline Hb value (OR: 0.51, 95% CI: 0.33-0.78 per 1 g/dL increase) was the only predictor of response at three months. The Hb value in the evaluable 60 patients at one yr increased from 9.9 ± 1.4 g/dL to 11.7 ± 1.7 g/dL (p < 0.001). Lower baseline Hb value (OR: 0.34, 95% CI: 0.18-0.65 per 1 g/dL increase) and a shorter time from transplantation (OR: 0.8, 95% CI: 0.68-0.94 per one yr increase) were predictors of response. Adverse events were reported in five patients (0.7% of doses). The rate of estimated glomerular filtration rate decline was reduced following the IV iron treatment -0.34 ± 1.05 mL/min/month after treatment compared with -0.81 ± 1.11 mL/min/month before treatment (p = 0.013).
IV iron treatment was safe and associated with Hb increase in a cohort of patients after kidney transplantation.
我们旨在评估静脉(IV)铁补充对血红蛋白(Hb)水平的影响,并发现治疗反应的预测因素。
这是一项回顾性队列研究,共纳入 81 例移植后接受 IV 铁治疗的患者。我们通过线性回归分析评估了治疗反应的预测因素,治疗反应定义为 Hb 值增加超过 1 g/dL。
治疗 3 个月后,平均 Hb 水平从 9.8±1.4 g/dL 显著增加至 11.1±1.6 g/dL(p<0.001)。较低的基线 Hb 值(OR:0.51,95%CI:每增加 1 g/dL 增加 0.33-0.78)是 3 个月时反应的唯一预测因素。60 例可评估患者的 Hb 值在 1 年时从 9.9±1.4 g/dL 增加至 11.7±1.7 g/dL(p<0.001)。较低的基线 Hb 值(OR:0.34,95%CI:每增加 1 g/dL 增加 0.18-0.65)和移植后时间较短(OR:0.8,95%CI:每增加 1 年增加 0.68-0.94)是反应的预测因素。5 例患者(剂量的 0.7%)报告了不良事件。与治疗前(治疗后 -0.81±1.11 mL/min/month)相比,IV 铁治疗后估计肾小球滤过率的下降速度降低(治疗后 -0.34±1.05 mL/min/month)(p=0.013)。
IV 铁治疗在肾移植后患者中是安全的,并与 Hb 增加相关。