Intravenous iron dextran therapy in patients with iron deficiency and normal renal function who failed to respond to or did not tolerate oral iron supplementation.

摘要: Abstract PURPOSE: To evaluate the safety and effectiveness of using 500-mg doses iron as intravenous dextran after premedication with diphenhydramine, cimetidine, dexamethasone. SUBJECTS AND METHODS: We treated 135 iron-deficient adults (26 men, 109 women) normal renal function (serum creatinine level ≤1.5 mg/dL or blood urea nitrogen ≤26 mg/dL) who could not be adequately oral supplements due to gastrointestinal symptoms (59%), inadequate hematologic response (39%), severe anemia (19%), noncompliance (4%). Some patients had more than one reason for treatment. Resolution deficiency was defined restoration transferrin saturation, serum ferritin level, anemia, abnormal erythrocyte indexes baseline values. RESULTS: Before treatment dextran, a mean (± SD) saturation 8% ± 5%, median 11 ng/mL, hemoglobin 10 2 g/dL. Ninety-two percent were anemic; 60% unrecognized untreated causes other deficiency. administered 285 infusions (median 2, per patient; range 1 7). Eighty-seven no adverse reaction; 13% mild reactions, especially arthralgias myalgias. No patient an anaphylaxis-like reaction. Fifty-four (40%) resolution deficiency, 34 (25%) continue receive therapy, 36 (27%) returned care their primary physician, (8%) died before repletion achieved. CONCLUSIONS: Iron-deficient cannot can effectively safely this regimen.