Dialysate iron therapy: infusion of soluble ferric pyrophosphate via the dialysate during hemodialysis.
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Gupta A, Amin NB, Besarab A, Vogel SE, Divine GW, Yee J, Anandan JV
Dialysate iron therapy: infusion of soluble ferric pyrophosphate via the dialysate during hemodialysis.
Kidney Int. 1999 May;55(5):1891-8. doi: 10.1046/j.1523-1755.1999.00436.x.
- PubMed ID
- 10231452 [ View in PubMed]
- Abstract
BACKGROUND: Soluble iron salts are toxic for parenteral administration because free iron catalyzes free radical generation. Pyrophosphate strongly complexes iron and enhances iron transport between transferrin, ferritin, and tissues. Hemodialysis patients need iron to replenish ongoing losses. We evaluated the short-term safety and efficacy of infusing soluble ferric pyrophosphate by dialysate. METHODS: Maintenance hemodialysis patients receiving erythropoietin were stabilized on regular doses of intravenous (i.v.) iron dextran after oral iron supplements were discontinued. During the treatment phase, 10 patients received ferric pyrophosphate via hemodialysis as monthly dialysate iron concentrations were progressively increased from 2, 4, 8, to 12 micrograms/dl and were then sustained for two additional months at 12 micrograms/dl (dialysate iron group); 11 control patients were continued on i.v. iron dextran (i.v. iron group). RESULTS: Hemoglobin, serum iron parameters, and the erythropoietin dose did not change significantly from month 0 to month 6, both within and between the two groups. The weekly dose of i.v. iron (mean +/- SD) needed to maintain iron balance during month 6 was 56 +/- 37 mg in the i.v. iron group compared with 10 +/- 23 mg in the dialysate iron group (P = 0.001). Intravenous iron was required by all 11 patients in the i.v. iron group compared with only 2 of the 10 patients receiving 12 micrograms/dl dialysate iron. The incidence of adverse effects was similar in both groups. CONCLUSIONS: Slow infusion of soluble iron pyrophosphate by hemodialysis may be a safe and effective alternative to the i.v. administration of colloidal iron dextran in maintenance hemodialysis patients.
DrugBank Data that Cites this Article
- Drugs
- Drug Targets
Drug Target Kind Organism Pharmacological Action Actions Ferric pyrophosphate Ferritin light chain Protein Humans YesBinderDetails Ferric pyrophosphate Hemoglobin subunit alpha Protein Humans YesBinderDetails Ferric pyrophosphate Hemoglobin subunit beta Protein Humans YesBinderDetails Ferric pyrophosphate citrate Ferritin heavy chain Protein Humans YesBinderDetails Ferric pyrophosphate citrate Ferritin light chain Protein Humans YesBinderDetails Ferric pyrophosphate citrate Hemoglobin subunit alpha Protein Humans YesBinderDetails Ferric pyrophosphate citrate Hemoglobin subunit beta Protein Humans YesBinderDetails