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ERİTROPOETİNE DİRENÇLİ RENAL ANEMİNİN TEDAVİSİNDE İNTRAVENÖZ DEMİR UYGULAMASI

INTRAVENEOUS IRON TREATMENT IN ERYTHROPOIETIN RESISTANT ANEMIA

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
In patients with chronic renal failure, erythropoietin (EPO) resistance is a great problem in treatment of anemia. One of the main reason of EPO resistance is iron deficienty anemia. Iron deficiency treated with oral iron preparations is frequently not sufficient and leads to unsatisfactory results in EPO treatment . In this group of patients it's claimed that intravenous (IV) iron treatment has succesful results. Here, we search for iron deficiency anemia in Epo resistant patients and the effectiveness of I.V. iron treatment in iron deficient patients. Twenty patients, showing resistance to treatment for 3 months of EPO and oral iron preparations, with mean hematocrit value 22,8±3 %, mean trasferrin saturation value 23,3±4 % and mean serum ferritin value J89,5±53 ng/dl were included in this study. After ruling out the other reasons of EPO resistance, we administered 20 patients WOnig iron hydroxysucrose complex for 3 times a week for a period of 3 months. After the end of third month mean hematocrit value increased to 31,28±3,0 %, mean transferrin saturation increased to 34,7±0,8 %, and mean serum ferritin increased to 311,7±101 ng/dl (p<O,OJ). The stastistically significant increase in Htc values shows intravenous iron treatment in anemia of patients with CRF using EPO is successful and confidental way of increasing the success of EPO treatment.
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Abstract (Original Language): 
Kronik renal yetmezlikti hastalarda anemi tedavisinde eritropoetine direnç büyük bir problemdir. Eritropoetine direncin ana sebeplerinden biri demir eksikliği anemisidir. Demir eksikliğinin oral demir preparatlarıyla tedavisi, eritropoetin (Epo) tedavisi sırasında yetersiz kalmaktadır. Bu nedenle bu grup hastalarda alternatif olarak IV demir tedavisi önerilmektedir. Biz de çalışmamızda Epo tedavisine dirençli olgularda IV demir uygulamasının etkinliğini araştırdık. Çalışmaya 3 aydan beri Epo tedavisi alan ortalama hematokrit (Htc) düzeyi % 22,8±3, transferrin satürasyonu % 23,3±4 ve serum ferritin düzeyi 189,5±53 ng/dl olan 20 hasta dahil edildi. Tedavide dirence sebep olabilecek diğer nedenlere bağlı olgular çalışma dışı bırakıldı. Olgulara haftada 3 kez lOOmg demir sükroz (Venofer ampul) 3 ay süreyle uygulandı. Tedavinin üçüncü ayında Htc değeri % 31,28±3,0 ferritin düzeyi 31I,7±101 Transferrin satürasyonu %o34,7±0,8'e yükseldi (p<0.001). Eritropoetine dirençli anemisi olan renal yetmezlikti olgularda I. V. demir tedavisinin herhangi bir komplikasyon oluşturmaksızın güvenle kullanılabileceği kanaatine varıldı.
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  • 1
49-52
  • Turkish

REFERENCES

References: 

1. Stevens J.M, Kurtz A.Eckardt KV, Vineatls C.G : Anamia in Chronic Renal failure. In Cameron S.Davison A.M Griinfeld J.P.Keer D.Eberhard (eds). Oxford textbook of Clinical Neprology . New-York 1992. 1344-1360.
2. Cappelini M.D, Bruntti C, Feo D.T: Uremia Inhibitors of Erythropoietin. AmJ.Neprol 1992; 12,9-13.
3. Grutzmacker P, Tjobanelis T, Toth P, Werner E: Effecct of recombinant human erythropoietin on iron balance in maintenance hemodialysis, theoretical, considerations clinical experience and consequences.Clin.Nephrol 1992:38 Supp:192-197.
4. York S: Current perspectives iron menagement during therapy with recombinant human erythropoietin. AnnJ.1993. 20(6) ;645-650.
5. Fishbane S, Frei G.L,Measeka J:Reduction in Recombinant human erythropoitein doses by the use of chronic intravenous iron supplemention .Am.J.Kidney
Dis. Jul 1995:26(l);41-46.
6. Nyvad O, Danielson H, Madsen S: intravenous iron-sucrase complex to reduce epoetin demand in dialysis
patients .The Lancet. 1995 (11 ):344; 1305-1306.
7. Silverberg D, İana A. Peer G. Kaplan E, Ami Cevi B, Frank N, Steindruch S, Blum M: İntravenos iron suplemention for the treatment of anemia of moderate to severe chronic renal failure patients not on dialysis .Am j Kidney. 1996:2:27-28.
51
8. El Reshaid K, Johny KU, Hakim A, Kamel H, Sebeta A, Hovroni H, Konyike FB. Erythropoietin treatment in hemodialysis patients with iron overload:Acta haematol 1994:91(3). 130-135
9. Watson A. Iron management during treatment with recombinant human erythropoietin in chronic renal failure.J Clin Pharmacol 1993 :13( 12); 1134-1138.
10. Barosi G, Merlo C, Palestca P, Liberato N.C,
Guearmone R.Didio F. Piazza V. Salvadeo A. Variations in erytropoiezis and serum ferritin jduring erytropoietin therapy for anameia of end-stage renal disease .Acta haematol. 1993:90( 1); 13-18.
11. Brunati C, Poperno A, Guastoni C, Perrino MC, Civati G,Teatini U, Perego A. Erythrocyte ferritin in patients on chronic hemodialysis treatment .Nephron 1990:54; 219-223.
12. Sunder PG, Hörl W. Iron metabolizm and iron substition during erytropoietin therapy . Clin Invest. 1994:72; 11-15.
13. Fishbane S, Lyon RI. The Utillity of zinc protoporphyrin for predicting the need for intravenous iron therapy in hemodialysis patients Am J Kidney Dis. 1995:25(3);426-432
14. Rosenlof K, Kiviwori SM, Granhagen Risca C, Teppo AM, Smiles MA. Iron availability is transiently improved by intravenous iron medication in patients on chronic hemodialysis. Clin Nephrol. 1995 43(4);249-255.
15. Casati S, Campite M, Ponticelli C. Correction of anemia with recombinant human eryhropoietin despite Low Serum ferritin. Nephrol Dial Transplant 1991(6)452-456.
16. Macdougall C. How to get the best out of r-
HuEPO.Neprol Dial Transplant. 1995 (10);85-91.

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