Related Experiment Video
Updated: Aug 14, 2026
05:23
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Intravenous iron therapy: well-tolerated, yet not harmless
G Sengölge1, W H Hörl, G Sunder-Plassmann
1Department of Medicine III, Medical University Vienna, Austria. Guerkan.Sengoelge@meduniwien.ac.at
European Journal of Clinical Investigation
|November 12, 2005
Summary
Intravenous iron therapy is crucial for chronic renal failure patients to maintain hemoglobin. While generally safe and effective, potential effects on infection and atherosclerosis warrant careful consideration.
Area of Science:
- Nephrology
- Hematology
- Pharmacology
Background:
- Chronic renal failure (CRF) often necessitates erythropoietic agents and iron supplementation to achieve target hemoglobin levels (e.g., >11 g/dL).
- Intravenous (IV) iron administration is recognized as more effective than oral iron for managing anemia in CRF patients.
- Commonly used IV iron formulations include iron(III)-hydroxide-sucrose complex (iron sucrose) and iron(III)-sodium-gluconate in sucrose (iron gluconate), generally demonstrating good tolerability.
Purpose of the Study:
- To review the efficacy and safety of intravenous iron therapy in patients with chronic renal failure.
- To discuss the potential adverse effects of IV iron, particularly concerning non-transferrin bound labile iron and its implications.
- To evaluate the association between iron therapy and risks of infection or atherosclerosis.
Main Methods:
- Review of existing literature on intravenous iron therapy in chronic renal failure.
- Analysis of studies investigating the effects of IV iron on cellular components and cytokines.
- Examination of clinical trial data regarding the safety and tolerability of iron sucrose.
Main Results:
- IV iron sucrose and iron gluconate are effective and generally well-tolerated for anemia management in CRF.
- IV iron can influence endothelial cells, polymorphonuclear leukocytes, and cytokines, potentially linked to labile iron.
- Evidence regarding iron's role in infection and atherosclerosis is conflicting; a recent trial indicated iron sucrose is safe for iron deficiency treatment and maintenance.
Conclusions:
- Intravenous iron therapy is essential for managing anemia in chronic renal failure patients.
- While generally safe, the potential impact of labile iron requires careful monitoring and consideration.
- Iron therapy should be administered judiciously when indicated, without undue fear, based on current evidence.
Related Concept Videos
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
01:00Drug Toxicity: Overview
Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
01:25Routes of Drug Administration: Parenteral
The administration of drugs via parenteral routes allows for direct drug introduction into the systemic circulation, resulting in high bioavailability because the medication bypasses the harsh conditions of the gastrointestinal tract and hepatic metabolism.
The intravenous route (IV) of drug administration can be further categorized into two types. The bolus injection administers the entire dose rapidly, while an intravenous infusion slowly delivers smaller doses steadily.
The IV route is often...
The intravenous route (IV) of drug administration can be further categorized into two types. The bolus injection administers the entire dose rapidly, while an intravenous infusion slowly delivers smaller doses steadily.
The IV route is often...
01:26Pharmaceutical Poisoning: Treatment Strategies
Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
01:24Hemodialysis II: Procedure and Complications
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
01:25Hemodialysis III: Nursing Management
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...