High-dose intravenously administered iron versus orally administered iron in blood donors with iron deficiency: study protocol for a randomised, controlled trial

Effectiveness of inulin-type on the iron bioavailability in anemic female rats fed bio-yogurt

It is well-documented that iron deficiency leads to anemia, which is the utmost critical problem of nutrition worldwide. Inulin, indigestible polysaccharides, or prebiotic agents may act as vehicles to enhance the iron bioavailability through the formation of the polysaccharide-iron complex. The present study was undertaken to evaluate the therapeutic effects of yogurt fortified with iron and supplemented by long- or short-chain inulin on the growth status, blood parameters, antioxidant capacity, and liver function enzymes in anemic rats. Five animal groups were assigned as the control (G1), which were fed a standard diet and there were four anemic groups, in which haemolytic anemia was induced by phenylhydrazine. The anemic rats were divided into 4 groups according to the regime of feeding as G2: control anemic group fed low-iron diet while the remaining anemic groups were fed yogurt fortified with Fe2(SO4)3 without inulin (G3) or with either long- (G4) or short-chain (G5) inulin. The results showed that the animals subjected to treatment G4 had the highest (P ≤ 0.05) weight gain and organ coefficient compared with other anemic groups (G2, G3, and G5). Among the anemic groups, the animals that belonged to G4 showed a significant restorative effect by returning the hemoglobin and hematocrit levels and the red blood cell count to the normal control liver. Also, the liver iron content, enzymatic activities, and antioxidant capacities improved in the animals subjected to G4 and G5 treatment groups. The histological structures of the liver tissues of the animals that belonged to G4 and G5 were extremely close to that of the normal control liver. Long-chain inulin-containing yogurt exhibited the best effects in terms of iron supplementation, bioavailability, and antioxidant activities. This formula might be a potential new iron supplement and a good functional food candidate.

Iron supplementation limits the deleterious effects of repeated blood donation on endurance sport performance but not on iron status

BACKGROUND

Every day, blood banks worldwide face the challenge of ensuring an adequate blood supply. Iron deficiency is by far the most common cause of deferral of blood donors. The aim of the present study was to determine the effect of iron supplementation after repeated blood donation on iron status and physiological performance.

MATERIALS AND METHODS

Forty-four moderately trained and iron-replete subjects were randomly divided into a whole blood donation (n=36) and a placebo donation (n=8) group. One third of the donation group received no iron supplementation, whereas one third received 20 mg iron and one third received 80 mg iron daily for 28 days. The subjects were intended to make three donations 3 months apart, and recovery of endurance capacity, assessed by an incremental maximal cycling test, and haematological parameters was monitored up to 28 days after each donation.

RESULTS

Negative effects of repeated blood donation were found for markers of iron storage, markers of functional iron and/or iron metabolism regulation, and physiological markers. Iron supplementation did not affect iron storage but did limit, at the highest dose of 80 mg, the effect of blood donations on functional iron and/or iron metabolism regulation, and at both 20 and 80 mg the negative effects on maximal power output and peak oxygen consumption.

DISCUSSION

Iron supplementation limited the deleterious effects of repeated blood donation on endurance sport performance but not on decline in iron status in iron-replete young men. These results underline the importance of iron supplementation to minimise the deleterious effects of blood donation on physiological functions, and the necessity to optimise the supplementation strategy to preserve iron status.

Sex- and Gender-Related Factors in Blood Product Transfusions

Blood products are indicated for a plethora of conditions in several settings, with a variety of products available for transfusion, from highly processed specific components to whole blood. Matching the donor product to the recipient is crucial in avoiding serious transfusion reactions, with the extent of matching depending on the physiological need, setting, and product. There are important factors related to sex and gender differences in donated blood products, adverse reactions to those products, interplay with underlying pathology, as well as sociocultural differences in the collection. This article will review key sex- and gender-specific research related to the use of blood products with an emphasis on the acute care setting.

The Effect of Parenteral or Oral Iron Supplementation on Fatigue, Sleep, Quality of Life and Restless Legs Syndrome in Iron-Deficient Blood Donors: A Secondary Analysis of the IronWoMan RCT

Background: Besides anemia, iron deficiency may cause more subtle symptoms, including the restless legs syndrome (RLS), the chronic fatigue syndrome (CFS) or sleeping disorders. Objective: The aim of this pre-planned secondary analysis of the IronWoMan randomized controlled trial (RCT) was to compare the frequency and severity of symptoms associated with iron deficiency before and after (intravenous or oral) iron supplementation in iron deficient blood donors. Methods/Design: Prospective, randomized, controlled, single-centre trial. (ClinicalTrials.gov: NCT01787526). Setting: Tertiary care center in Graz, Austria. Participants: 176 (138 female and 38 male) whole-blood and platelet apheresis donors aged ≥ 18 and ≤ 65 years with iron deficiency (ferritin ≤ 30ng/mL at the time of blood donation). Interventions: Intravenous iron (1 g ferric carboxymaltose, n = 86) or oral iron supplementation (10 g iron fumarate, 100 capsules, n = 90). Measurements: Clinical symptoms were evaluated by a survey before iron therapy (visit 0, V0) and after 8–12 weeks (visit 1, V1), including questions about symptoms of restless legs syndrome (RLS), chronic fatigue syndrome (CFS), sleeping disorders, quality of life and symptoms like headaches, dyspnoea, dizziness, palpitations, pica and trophic changes in fingernails or hair. Results: We found a significant improvement in the severity of symptoms for RLS, fatigue and sleep quality (p < 0.001). Furthermore, a significant decrease in headaches, dyspnoea, dizziness and palpitations was reported (p < 0.05). There was no difference between the type of iron supplementation (intravenous versus oral) and clinical outcome data. Conclusion: Iron supplementation in iron-deficient blood donors may be an effective strategy to improve symptoms related to iron deficiency and the wellbeing of blood donors.

Donor Iron Deficiency Study (DIDS): protocol of a study to test whether iron deficiency in blood donors affects red blood cell recovery after transfusion

BACKGROUND

Despite fulfilling all requirements for blood donation, a large proportion of regular blood donors are iron deficient. Red blood cells (RBC) from iron-deficient donors may be particularly susceptible to damage induced by standard refrigerated storage. Herein, we present a study protocol for testing whether correcting iron deficiency in donors with iron-deficient erythropoiesis will improve the quality of their refrigerator-stored RBC.

MATERIALS AND METHODS

This is a randomised, controlled, double-blind clinical trial. Sixty healthy regular donors who meet donation standards, while exhibiting iron-deficient erythropoiesis by laboratory testing criteria, will donate a single standard RBC unit that will be leucoreduced and stored in a refrigerator under standard conditions for 40-42 days. A 51Cr-radiolabelled 24-hour RBC recovery study will be performed and then these donors will be randomised to receive, in a double-blinded fashion, either intravenous saline, as a control, or low-molecular weight iron dextran (1 g), to provide total iron repletion. Four to six months later, they will donate a second RBC unit, which will be similarly stored, and autologous 51Cr-labelled 24-hour post-transfusion RBC recovery will again be determined.

RESULTS

The primary endpoint will be the change in 24-hour post-transfusion recovery from the first to the second donation. The primary outcome will be the group mean difference in the primary endpoints between the group receiving intravenous saline and the group receiving intravenous iron dextran. Secondary outcomes will be quality of life, fatigue, and emotional health, assessed by surveys.

CONCLUSION

This study will provide definitive evidence as to whether donor iron deficiency affects the quality of the blood supply and will assess the severity of symptoms affecting iron-deficient blood donors.

Effectiveness of AOS–iron on iron deficiency anemia in rats

Iron deficiency anemia (IDA) is one of the most serious nutritional problems. This study aimed to evaluate the therapeutic effects of a novel agar oligosaccharide–iron complex (AOS–iron) on rats with IDA, such as iron supplementation and recovery of antioxidant ability. Eighty-four weaned male SD rats were randomly divided into a normal control group (n = 12), which was fed with a standard diet, and an anemia model group (n = 72), which was fed with an iron-deficient diet for 4 weeks to establish a model of IDA. After the model was established, the rats with IDA were divided into six groups, namely, an anemia model group, a ferrous gluconate group, a ferrous sulfate (FeSO₄) group, and low-dose (LD), medium-dose (MD) and high-dose (HD) AOS–iron groups, and fed with an iron-deficient diet and different iron supplements for 4 weeks, respectively. The results showed that HD AOS–iron exerted a significant restorative effect by returning blood parameters to normal levels in rats with IDA, including hemoglobin, red blood cells, hematocrit, mean cell volume, mean cell hematocrit, mean cell hemoglobin concentration, serum iron, total iron binding capacity, transferrin saturation, and serum ferritin. A histological analysis suggested that the liver morphology in the MD and HD AOS–iron groups was similar to that in the normal group. Furthermore, MD and HD AOS–iron improved antioxidant activities in the serum and liver. In general, high-dose (the same dose as those of ferrous gluconate and FeSO₄) AOS–iron exhibited the best effects in terms of iron supplementation and antioxidant activities. The present findings showed that AOS–iron might be a potential new iron supplement.

Iron deficiency anemia (IDA) is one of the most serious nutritional problems.

A metabolomics approach for predicting the response to intravenous iron therapy in peritoneal dialysis patients with anemia

Anemia is an almost universal complication of chronic kidney disease (CKD), and nearly all patients with end-stage renal disease (ESRD) and approximately 70% of those with earlier stages of CKD receive treatment for anemia.