Objective To evaluate the efficacy and safety of iron isomaltoside in the treatment of iron deficiency anemia in patients undergoing maintenance hemodialysis(MHD). Methods A retrospective analysis was conducted on 23 MHD patients with iron deficiency anemia. who received intravenous infusion of iron isomaltoside (500 mg per dose, twice in total, with an interval of 1 week), and then were followed up for 6 months. Changes in hemoglobin (Hb), transferrin saturation (TSAT), ferritin (Fer), adverse reactions,and changes in the dosage of anemia treatment drugs were observed. Results After treatment, Hb significantly increased. At 1 month, the median Hb rose from the baseline of 98.5 g/L to 113.0 g/L, the difference was statistically significant (P＜0.05),the median Hb during the peak period (2-5 months) remained at 115.0-117.5 g/L, and was maintained at 115.0g/L at 6 months (P=0.016). TSAT and Fer increased from the baseline of 14.3% and 55.9 μg/L to the peak values of 32.3% (P=0.010) and 436.0 μg/L (P=0.016) (3 months), respectively, it dropped back to 22.3% (P=0.047) and 99.0 μg/L (P=0.031) at 6 months, but was still significantly higher than the baseline, the difference was statistically significant. Only one patient (2%) exhibited a mild allergic reaction. The dosage of ESAs decreased significantly (P=0.012).The overall response Hb rate (Hb≥110g/L) increased from 17.4%(4/23) at baseline to 65.2%(15/23) at 6 months (P＜0.05). Conclusions Iron isomaltoside can effectively improve iron metabolism and anemia in MHD patients, with favorable safety, which holds clinical promotion value.
Key words
iron isomaltoside /
anemia /
hemodialysis /
hemoglobin /
ferritin
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Besarab A,Coyne D W.Iron supplementation to treat anemia in patients with chronic kidney disease[J].Nat Rev Nephrol,2010,6(12):699-710.
[2] Tsukamoto T,Matsubara T,Akashi Y,et al.Annual iron loss associated with hemodialysis[J].Am J Nephrol, 2016,4(3):32-38.
[3] 中华医学会肾脏病学分会肾性贫血诊断和治疗共识专家组.肾性贫血诊断与治疗中国专家共识(2018修订版)[J].中华肾脏病杂志,2018,34(11):860-866.
[4] 中国医师协会肾脏内科医师分会肾性贫血指南工作组.中国肾性贫血诊治临床实践指南[J].中华医学杂志,2021,101(20):1463-1502.
[5] Macginley R,Walker R.Irving MKha Cari Guideline:use of iron in chronic kidney disease patients[J].Nephrology(Carlton),2013,18(12):747-749.
[6] Snook J,Bhala N,Beales I,et al.British society of gastroenterology guidelines for the management of iron deficiency anaemia in adults[J].Gut, 2021, 70(11): 2030-2051.
[7] Biggar P,Leistikow F,Walper A.A prospective observational study of effectiveness and safety of iron isomaltoside in patients with chronic renal failure and iron deficiency anemia[J].Clin Nephrol,2016,86(6): 310-318.
[8] Kalra P A,Bhandari S,Saxena S,et al.A randomized trial of iron isomaltoside 1000 versus oral iron in non-dialysis-dependent chronic kidney disease patients with anaemia[J].Nephrol Dial Transpl,2016,31(4): 646-655.
[9] Kalra P A,Bhandari S.Efficacy and safety of iron isomaltoside(Monofer) in the management of patients with iron deficiency anemia[J].Int J Nephrol Renovasc Dis,2016,9:53-64.
[10] Kalra P A,Bhandari S,Spyridon M,et al.NIMO-CKD-UK:a real-world,observational study of iron isomaltoside in patients with iron deficiency anaemia and chronic kidney disease[J].BMC Nephrol,2020,21(1): 539-549.
[11] Achebe M M,Glaspy J,Kalra P A,et al.A 6 month extension trial evaluating safety and efficacy of ferric derisomaltose in patients with iron deficiency anemia:the FERWON-EXT trial[J].Am J Hematol,2020,95(10): E276-279.
[12] Jensen G,Gøransson L,Fernström A,et al.Treatment of iron deficiency in patients with chronic kidney disease: a prospective observational study of iron isomaltoside(NIMO Scandinavia)[J].Clin Nephrol,2019,39(2): 246-253.
[13] Sunil B,Kalra P A,Mario B,et al.Safety and efficacy of iron isomaltoside 1000/ferric derisomaltose versus iron sucrose in patients with chronic kidney disease:the ferwon-nephro randomized,opelabel,comparative trial[J]. Nephrol Dial Transplant,2021,36(1):111-120.
[14] Emma E,Maneka S,Penelope P,et al.Ferric derisomaltose evaluation in patients with non-dialysis-dependent chronic kidney disease or peritoneal dialysis[J].Can J Hosp Pharm,2023,76(2):94-101.
[15] Palmer S C,Navaneethan S D,Craig J C,et al.Meta-analysis: erythropoiesis-stimulating agents in patients with chronic kidney disease[J].Ann Intern Med,2010,153(1):23-33.
[16] Pollock R F,Muduma G.A budget impact analysis of parenteral iron treatments for iron deficiency anemia in the UK: reduced resource utilization with iron isomaltoside 1000[J].Clinicoecon Outcomes Res,2017,9:475-483.
[17] Pollock R F,Biggar P.Indirect methods of comparison of the safety of ferric derisomaltose, iron sucrose and ferric carboxymaltose in the treatment of iron deficiency anemia[J].Expert Rev Hematol,2020,13(2):187-195.
[18] 蒋亚芬,武 蓉.异麦芽糖酐铁治疗维持性血液透析患者缺铁性贫血的临床疗效分析[J].湖南师范大学学报(医学版),2024,21(2):124-126,132.
PDF(929 KB)
