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Safety of total dose iron dextran infusion in geriatric patients with chronic kidney disease and iron deficiency anemia
Authors:Neville R Dossabhoy  Steven Turley  Rebecca Gascoyne  Mihaly Tapolyai  Karina Sulaiman
Affiliation:1. Department of Medicine, Louisiana State University School of Medicine – Shreveport LAUSA;2. Department of Medicine, Overton Brooks Veteran Affairs Medical Center – Shreveport LAUSA;3. Department of Surgery, Northern Indiana HealthCare System – Fort Wayne INUSA;4. Department of Medicine, WJB Dorn Veteran Affairs Medical Center – Columbia SCUSA;5. Department of Medicine, Edward Via Osteopathic School of Medicine Carolinas Campus – Spartanburg, SCUSA
Abstract:There are limited data on total dose infusion (TDI) using iron dextran in geriatric chronic kidney disease (CKD) patients with iron-deficiency anemia (IDA). Our goal was to evaluate the safety of TDI in this setting. We conducted a retrospective chart review spanning a 5 year period (2002–2007), including all patients with CKD and IDA who were treated with iron dextran TDI. Patient demographics were noted, and laboratory values for creatinine, hemoglobin and iron stores were recorded pre- and post-dose. TDI diluted in normal saline was administered intravenously over 4-6 hours after an initial test dose. One hundred fifty-three patients received a total of 250 doses of TDI (mean?±?SD?=?971?±?175?mg); age was 69?±?12 years and creatinine 3.3?±?1.9?mg/dL. All stages of CKD were represented (stage 4 commonest). Hemoglobin and iron stores improved post-TDI (P?P?=?0.1433 by Fishers Exact Test). Iron dextran TDI is relatively safe and effective in correcting IDA in geriatric CKD patients. Fewer AEs were noted with the LMW compared to the HMW product. LMW iron dextran given as TDI can save both cost and time, helping to alleviate issues of non-compliance and patient scheduling.
Keywords:Chronic kidney disease  geriatrics  iron deficiency anemia  iron dextran  safety  total dose iron
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