| Iron overdose: a contributor to adverse outcomes in randomized trials of anemia correction in CKD. | |
| | |
MedLine Citation:
|
PMID: 21744260 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Administration of intravenous iron to supplement erythropoiesis stimulating agents (ESAs) has become a common practice in the management of anemia in patients with end-stage renal disease. Randomized clinical trials of anemia correction in this population have shown more adverse outcomes in CKD and ESRD patients assigned to the higher hemoglobin targets. Retrospective analysis of these trials suggests that morbidity is higher in subjects who fail to achieve the designated hemoglobin target and are typically exposed to higher doses of ESAs and iron than those that easily achieve the intended targets. Intravenous iron administration circumvents the natural biologic mechanisms for handling and utilization of iron. There is in vitro and in vivo evidence that intravenous iron preparations can cause oxidative stress, endothelial dysfunction, inflammation, impaired immunity, and renal injury. Since iron overload is known to promote endothelial dysfunction, cardiovascular disease, and immune dysfunction which are the leading causes of premature mortality in CKD and ESRD patients, it is imperative to exercise caution with the use of IV iron preparations in this population. The present review is intended to provide a brief overview of the potential adverse effects of the overzealous use of these agents. |
| | |
Authors:
|
Peter Van Buren; Ruben L Velez; Nosratola D Vaziri; Xin J Zhou |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-7-10 |
Journal Detail:
|
Title: International urology and nephrology Volume: - ISSN: 1573-2584 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
|
Created Date: 2011-7-11 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0262521 Medline TA: Int Urol Nephrol Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Departments of Internal Medicine/Nephrology, University of Texas Southwestern Medical Center, Dallas, TX, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Recombinational histories of avian infectious bronchitis virus and turkey coronavirus.
Next Document: Characterization of novel small RNAs from tea (Camellia sinensis L.).