![]() ![]() ![]() Moreover, IV iron can lead to neutrophil and monocyte dysfunction. NTBI causes the formation of reactive oxygen species (ROS), which damage the endothelium, promote endothelial dysfunction and cause inflammation. The mainside effects of IV iron are ascribed to the abrupt rise in serum levels of non-transferrin-bound iron (NTBI). However, the excessive and indiscriminate use of IV iron preparations can have insidious and serious adverse consequences, including iron overload, cardiovascular disease, immune deficiency and a potential increase in the risk of microbial infections. Because iron deficiencies must be corrected in order to increase Hb levels, moderate doses of ESAs should be administered to achieve the desired Hb levels. Under conditions of renal anaemia, the administration of iron is essential because absolute and functional iron deficiencies are common. The use of intravenous (IV) iron to treat renal anaemia is currently increasing. The Hb target level has consequently been lowered, decreasing the need for high doses of ESAs. However, recent clinical trials have reported controversial outcomes with regards to higher haematocrit levels as well as high doses of ESAs. In CKD patients undergoing HD, anaemia was treated with blood transfusions prior to the introduction of recombinant erythropoiesis-stimulating agents (ESAs). Therefore, the adequate management of anaemia is considered to be one of the most important factors in treating HD patients.Īnaemia, a common complication of CKD, has a complex pathogenesis and mainly arises due to inadequate erythropoietin production, insufficient iron storage, inflammation, vitamin B12 and folic acid depletion, severe secondary hyperparathyroidism and blood loss during the HD procedure. However, randomised controlled trials have shown that normal Hb values are not associated with better survival. Low haemoglobin (Hb) levels have been associated with higher mortality, increased cardiovascular events and reduced health-related quality of life in HD patients. This mortality risk is partly related to the severity of the patients’ anaemia, which has been associated with adverse clinical outcomes. Patients with chronic kidney disease (CKD) stage 5D on haemodialysis (HD) have increased mortality rates. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are creditedĭata Availability: All relevant data are within the paper.įunding: This study was supported by the Fundación Nefrológica, Hospital Universitario Reina Sofia, Córdoba, Spain. Received: Accepted: JPublished: August 31, 2015Ĭopyright: © 2015 Agüera et al. Connor, The Pennsylvania State University Hershey Medical Center, UNITED STATES (2015) Efficiency of Original versus Generic Intravenous Iron Formulations in Patients on Haemodialysis. Citation: Agüera ML, Martin-Malo A, Alvarez-Lara MA, Garcia-Montemayor VE, Canton P, Soriano S, et al. ![]()
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