不再被忽视:静脉注射铁后的低酸血症
Matthijs Strubbe1, Karel David1, Bernard Peene2
1Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
Reviews in endocrine & metabolic disorders
|December 8, 2024
概括
静脉注射铁,特别是铁性碳酸,可以导致脏酸盐由于纤维细胞生长因子23的浪费. 早期诊断和切换配方可以预防潜在的代谢性骨病.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 血液学 血液学 血液学
背景情况:
- 静脉注射 (IV) 铁对于治疗缺铁性贫血至关重要.
- 一些IV铁配方与脏酸盐消耗综合征有关.
- 这种由纤维细胞生长因子23 (FGF23) 介导的综合征,由于意识不足和非特异性症状,往往没有得到报道.
研究的目的:
- 审查IV铁诱导的低度血症的流行病学和病理生理学.
- 提高临床医生对这种潜在并发症的认识.
- 突出风险因素和预防策略.
主要方法:
- 审查现有文献,包括病例报告和随机对照试验.
- 对病理生理学的分析,将IV铁配方与FGF23和酸盐浪费联系起来.
- 确定风险因素和临床表现.
主要成果:
- 输液铁诱导的低酸血症可能导致代谢性骨病,模仿低酸血症的风或瘤性骨质疏松症.
- 铁性碳酸与这种综合症特别相关,可能是由于其碳水化合物部分.
- 风险因素包括重复输液,严重的铁缺乏,正常的功能,以及同时存在的维生素D缺乏或甲状腺功能障碍.
结论:
- 输液铁诱导的低酸血,虽然往往是自我限制的,但可以引起显著的临床症状和骨疾病.
- 早期识别,诊断和切换到替代IV铁配方可以预防并发症.
- 提高处方医生的意识对于管理和预防这种不良影响至关重要.
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