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Portolés-Pérez J, Durá-Gúrpide B, Merino-Rivas JL, Martín-Rodriguez L, Hevia-Ojanguren C, Burguera-Vion V, Yuste-Lozano C, Sánchez-García L, Rodriguez-Palomares JR, Paraiso V. Effectiveness and safety of ferric carboxymaltose therapy in peritoneal dialysis patients: an observational study. Clin Kidney J 2019; 14:174-180. [PMID: 33564416 PMCID: PMC7857829 DOI: 10.1093/ckj/sfz153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/30/2019] [Indexed: 02/06/2023] Open
Abstract
Background The efficacy of intravenous (IV) ferric carboxymaltose (FCM) has been demonstrated in haemodialysis and non-dialysis studies, but evidence is lacking in patients undergoing peritoneal dialysis (PD). Methods This multicentre, retrospective study evaluated the effectiveness and safety of FCM in patients on PD over 12 months. We retrospectively reviewed the electronic medical records of PD patients who initiated FCM treatment between 2014 and 2017 across seven Spanish centres. Results Ninety-one patients were included in the safety population (mean ± SD age 57.7 ± 15.0 years) and 70 in the efficacy population (mean age 50.9 ± 14.5 years). No hypersensitivity reaction, FCM discontinuation or dose adjustment due to a serious adverse event (SAE) was registered in the safety population. The most common non-SAEs reported were headache (four events), mild hypotension (three events) and hypertension (two events), among others. In the efficacy population (n = 70), 68.6% of patients achieved ferritin levels of 200–800 ng/mL, 78.4% achieved transferrin saturation (TSAT) >20%, and 62.8% achieved TSAT >20% and ferritin >200 ng/mL after 12 months of FCM initiation (P < 0.01). Haemoglobin (Hb) levels were maintained at >11 g/dL with a lower dose of darbepoetin throughout the follow-up. The sub-analysis of patients naïve to IV iron and with absolute or relative iron deficiency (n = 51) showed that 76.5% reached ferritin >200 ng/mL, 80.4% TSAT >20% and Hb increased (1.2 g/dL) after 4 months of FCM treatment (P < 0.01). Conclusion In this multicentre, retrospective, real-world study conducted in the PD population, FCM was effective, safe and easy to administer during routine clinical visits.
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Affiliation(s)
- Jose Portolés-Pérez
- Nephrology Department, University Hospital Puerta de Hierro, Madrid, Spain.,RedInRen ISCiii 016/009 Public Research Net, Madrid, Spain
| | - Beatriz Durá-Gúrpide
- Nephrology Department, University Hospital Puerta de Hierro, Madrid, Spain.,RedInRen ISCiii 016/009 Public Research Net, Madrid, Spain
| | | | - Leyre Martín-Rodriguez
- Nephrology Department, University Hospital Puerta de Hierro, Madrid, Spain.,RedInRen ISCiii 016/009 Public Research Net, Madrid, Spain
| | | | - Victor Burguera-Vion
- RedInRen ISCiii 016/009 Public Research Net, Madrid, Spain.,Nephrology Department, University Hospital Ramón y Cajal, Madrid, Spain
| | - Claudia Yuste-Lozano
- RedInRen ISCiii 016/009 Public Research Net, Madrid, Spain.,Nephrology Department, University Hospital Doce de Octubre, Madrid, Spain
| | | | | | - Vicente Paraiso
- Nephrology Department, University Hospital del Henares, Coslada, Madrid, Spain
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Zeidan A, Bhandari S. Anemia in Peritoneal Dialysis Patients; Iron Repletion, Current and Future Therapies. Perit Dial Int 2017; 37:6-13. [PMID: 28153964 DOI: 10.3747/pdi.2016.00193] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 07/24/2016] [Indexed: 12/23/2022] Open
Abstract
Iron deficiency, both functional and absolute, is common in patients with chronic kidney disease (CKD), especially those requiring dialysis. Guidelines advocate treatment of iron-deficiency anemia in patients with CKD and those on peritoneal dialysis (PD). Oral iron is often insufficient and slow to improve hemoglobin concentrations because of high hepcidin levels causing impaired absorption and mobilization, while intravenous (IV) supplementation replenishes and maintains iron stores more effectively and is now standard practice (Kidney Disease Improving Global Outcomes [KDIGO] 2012 guidelines). However, there still remain concerns about the effects of labile iron and possible increased risk of infections for this group of patients.To date, the majority of published studies have focused on hemodialysis (HD) patients; very limited data are available regarding patients on PD. This review summarizes the rationale for iron therapy, methods of treatment, potential adverse effects, and long-term concerns in PD patients. In addition we highlight some interesting potential future therapies under study.
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Affiliation(s)
- Ahmed Zeidan
- Department of Academic Renal Research, Hull and East Yorkshire Hospital Trust and Hull York Medical School, Kingston Upon Hull, UK
| | - Sunil Bhandari
- Department of Academic Renal Research, Hull and East Yorkshire Hospital Trust and Hull York Medical School, Kingston Upon Hull, UK
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Auerbach M, Goodnough LT, Shander A. Iron: The new advances in therapy. Best Pract Res Clin Anaesthesiol 2013; 27:131-40. [DOI: 10.1016/j.bpa.2012.12.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 12/17/2012] [Indexed: 01/04/2023]
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