Division of Nephrology and Hypertension, Departments of Medicine and Physiology and Biophysics, University of California, Irvine, Orange, CA 92868, USA.
Am J Kidney Dis. 2013 Jun;61(6):992-1000. doi: 10.1053/j.ajkd.2012.10.027. Epub 2013 Jan 31.
Although judicious use of intravenous iron preparations is an indispensable part of anemia treatment in hemodialysis patients, their excessive and indiscriminate use can have insidious but serious adverse consequences. With recent implementation of the bundling reimbursement policy, use of intravenous iron preparations in the hemodialysis population has markedly increased. Excessive use of these agents potentially can exacerbate oxidative stress, inflammation, endothelial dysfunction, cardiovascular disease, and immune deficiency and potentially increases the risk of microbial infections in this population. Most of these adverse effects are mediated by iron-catalyzed generation of reactive oxygen species and the resultant cell injury and dysfunction. This review is intended to provide an overview of the nature and mechanisms of the adverse effects of iron overload and call for the judicious use of these vitally important products.
虽然合理使用静脉铁剂是血液透析患者贫血治疗中不可或缺的一部分，但过度和不加选择地使用会产生潜在但严重的不良后果。随着最近捆绑报销政策的实施，血液透析人群中静脉铁剂的使用明显增加。这些药物的过度使用可能会加剧氧化应激、炎症、内皮功能障碍、心血管疾病和免疫缺陷，并可能增加该人群发生微生物感染的风险。这些不良反应大多是由铁催化生成的活性氧自由基引起的细胞损伤和功能障碍所致。本综述旨在概述铁过载的不良影响的性质和机制，并呼吁合理使用这些至关重要的产品。
