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Intravenous Iron Repletion Does Not Significantly Decrease Platelet Counts in CKD Patients with Iron Deficiency

Neville R Dossabhoy1, Rebecca Gascoyne, Steven Turley

  • 1Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71130-3932, USA ; Department of Medicine, Overton Brooks Veterans Affairs Medical Center, Shreveport, LA 71101, USA.

International Journal of Nephrology
|March 12, 2013
PubMed

Insights

Intravenous iron repletion in chronic kidney disease (CKD) patients with iron deficiency anemia (IDA) did not significantly impact platelet counts. This study found no significant decrease in platelets after iron dextran total dose infusion (TDI).

Area of Science:

  • Nephrology
  • Hematology
  • Pharmacology

Background:

  • Iron deficiency anemia (IDA) is common in chronic kidney disease (CKD).
  • Platelet (PLT) count alterations can occur in CKD patients.
  • The effect of intravenous (IV) iron repletion on PLT counts in CKD-IDA requires further investigation.

Purpose of the Study:

  • To investigate the impact of IV iron repletion on platelet counts in CKD patients with IDA.
  • To determine if iron dextran total dose infusion (TDI) affects PLT levels in this population.

Main Methods:

  • Retrospective chart review of CKD patients with IDA treated with iron dextran TDI between 2002 and 2007.
  • Collected demographic and laboratory data including creatinine, hemoglobin (Hgb), iron stores, and PLT counts pre- and post-TDI.
  • Analyzed data stratified by molecular weight (MW) and dose of iron dextran.

Main Results:

  • 153 patients received 251 doses of iron dextran TDI.
  • Hemoglobin and iron stores significantly improved post-TDI (P ≪ 0.001).
  • A non-significant mild decrease in PLT counts was observed (pre-TDI 255 vs. post-TDI 244, P = 0.30), irrespective of iron dextran MW or dose.

Conclusions:

  • Correction of iron deficiency with IV iron dextran TDI does not significantly lower platelet counts in CKD patients.
  • The correlation between platelet counts and the severity of iron deficiency was weak.
  • Clinical management of IDA in CKD patients with IV iron is unlikely to cause significant thrombocytopenia.

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