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Iron Deficiency in Long-Term Parenteral Nutrition Therapy
Yi L Hwa1, Shahrooz Rashtak1, Darlene G Kelly1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
JPEN. Journal of Parenteral and Enteral Nutrition
|May 15, 2015
Summary
Patients on home parenteral nutrition (HPN) are at high risk for iron deficiency anemia (IDA). Parenteral iron replacement effectively improves iron status and hemoglobin levels in these patients.
Area of Science:
- Parenteral Nutrition
- Hematology
- Gastroenterology
Background:
- Iron is not routinely added to parenteral nutrition (PN) in the US due to safety concerns.
- Limited data exist on iron status and iron deficiency anemia (IDA) in long-term home PN (HPN) patients.
- Previous studies suggest iron dextran is safe in non-lipid PN solutions.
Purpose of the Study:
- To determine the incidence of IDA in patients receiving HPN.
- To examine the effectiveness of parenteral iron replacement in HPN patients.
Main Methods:
- Retrospective review of medical records for HPN patients at Mayo Clinic (1977-2010).
- Extracted data on diagnoses, time to IDA development, and iron indices (hemoglobin, ferritin, MCV).
- Investigated the response to intravenous iron replacement therapy.
Main Results:
- 32.4% of HPN patients (60/185) were iron deficient.
- 37 out of 93 patients with sufficient iron stores developed IDA after a mean of 27.2 months.
- Parenteral iron replacement significantly improved iron status: ferritin (10.9 to 107.6 mcg/L), hemoglobin (11.0 to 12.5 g/dL), and MCV (84.5 to 89.0 fL).
Conclusions:
- Patients on HPN are susceptible to developing iron deficiency anemia.
- Iron supplementation should be considered for patients reliant on HPN.
Keywords:
dysmotilityfistulaehome parenteral nutritionintravenous iron replacementiron deficiency anemiashort bowel syndromesmall bowel obstructionMore Related Videos
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