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心肾综合征与铁剂补充:利大于弊?一篇综述。

Cardiorenal syndrome and iron supplementation-more benefits than risks: a narrative review.

机构信息

Center for Nephrology "G. Papadakis", General Hospital of Nikaia, Piraeus "Agios Panteleimon", 18454, Piraeus, Nikaia, Greece.

Department of Nephrology, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece.

出版信息

Int Urol Nephrol. 2024 Feb;56(2):597-606. doi: 10.1007/s11255-023-03741-8. Epub 2023 Aug 22.

Abstract

Intravenous iron administration has emerged as a crucial intervention for managing patients with cardiorenal syndrome (CRS) and iron deficiency, with or without the presence of anemia. Multiple studies have demonstrated the benefits of intravenous iron supplementation in improving anemia, symptoms, and functional capacity in patients with HF and iron deficiency. Furthermore, iron supplementation has been associated with a reduction in hospitalizations for HF exacerbation and the improvement of patients' quality of life and clinical outcomes. In addition to its effects on HF management, emerging evidence suggests a potential positive impact on kidney function in patients with CRS. Studies have shown an increase in estimated glomerular filtration rate and improvements in renal function markers in patients receiving intravenous iron therapy, highlighting the potential of this intervention in patients with CRS. This paper reviews the existing literature on the impact of intravenous iron therapy in these patient populations and explores its effects on various clinical outcomes. Future research endeavors are eagerly awaited to further improve our understanding of its clinical implications and optimize patient outcomes.

摘要

静脉铁剂治疗已成为治疗伴有或不伴有贫血的心力肾综合征(CRS)和缺铁患者的重要干预措施。多项研究表明,静脉铁剂补充可改善心力衰竭伴缺铁患者的贫血、症状和功能能力。此外,铁补充与心力衰竭恶化住院减少以及患者生活质量和临床结局改善相关。除了对心力衰竭管理的影响外,新出现的证据表明静脉铁剂治疗对 CRS 患者的肾功能可能有积极影响。研究表明,接受静脉铁剂治疗的患者估算肾小球滤过率增加,肾功能标志物改善,突出了该干预措施在 CRS 患者中的潜在作用。本文综述了静脉铁剂治疗这些患者人群的现有文献,并探讨了其对各种临床结局的影响。期待未来的研究努力进一步提高我们对其临床意义的理解并优化患者结局。

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