The safety and efficacy of an accelerated iron sucrose dosing regimen in patients with chronic kidney disease

• Published in: Kidney international Vol. 64; no. S87; pp. S72 - S77
• Main Authors: Blaustein, Daniel A., Schwenk, Michael H., Chattopadhyay, Jyoti, Singh, Harinder, Daoui, Rachid, Gadh, Radjeep, Avram, Morrell M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2003; Elsevier Limited
• Subjects: Aged; anemia; Anemia - drug therapy; Anemia - etiology; Blood Pressure - drug effects; chronic kidney disease; Female; Ferric Compounds - administration & dosage; Ferric Compounds - adverse effects; Ferric Oxide, Saccharated; ferritin; Ferritins - blood; Glucaric Acid; Humans; Infusions, Intravenous; iron sucrose; Kidney Failure, Chronic - complications; Male; Middle Aged; Prospective Studies; Transferrin - metabolism; transferrin saturation; Treatment Outcome; transferrin saturation; ferritin; chronic kidney disease; iron sucrose; anemia
• ISSN: 0085-2538; 0098-6577; 1523-1755
• DOI: 10.1046/j.1523-1755.64.s87.11.x

The safety and efficacy of an accelerated iron sucrose dosing regimen in patients with chronic kidney disease Provision of adequate iron to support erythropoiesis in patients with chronic kidney disease (CKD) is time consuming and may present adherence problems for patients in the outpatient setting. We studied an accelerated regimen of high-dose intravenous iron sucrose therapy in a cohort of iron-deficient, anemic CKD patients. Intravenous iron sucrose 500mg was infused over three hours on two consecutive days in 107 CKD patients (glomerular filtration rate, 32.3 ± 19.6mL/min/1.73m2, baseline hemoglobin 10.2 ± 1.7g/dL). Iron indices (transferrin saturation, ferritin) were measured at baseline and at two and seven days after completion of the iron regimen. Blood pressures were monitored immediately prior to, and hourly throughout the iron sucrose infusions. Transferrin saturation and serum ferritin increased from 18.5 ± 8.5% and 177 ± 123.8ng/mL at baseline to 40.2 ± 22.3% and 811 ± 294.1ng/mL in 102 evaluated patients (P < 0.015). In 55 patients with additional measurements at 7days post-dosing, the transferrin saturation and ferritin had fallen to 26.3 ± 10.6% and 691 ± 261.8ng/mL (P < 0.015 compared to two days' post-dose). Blood pressure rose slightly, but not significantly, throughout the infusions, and altering the infusion rate was not necessary. Two patients had seven adverse events that were considered related to iron sucrose. An accelerated regimen of high-dose intravenous iron sucrose therapy in CKD patients is safe and effective in restoring iron stores, and may potentially save time and improve patient adherence.