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SON DÖNEM BÖBREK YETMEZLİĞİNDEKİ DEMİR EKSİKLİĞİ ANEMİSİNİN İNTRAVENÖZ DEMİR SÜKROZ İLE TEDAVİSİ

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2003

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
The effect of iron sucrose in iron defîcieney anaeınia of end-stage. renal disease, Iron defici-eney is onc of the most important causes of anaemİa associaled with end-stage renal disease (ESRD) and there is no standard approach for the treatment. In this sludy we aimcd to study the effect and side effects of intravenous iron sucrose use İn patients with newly diagnosed ESRD and iran deficieney anaemia. 46 patients (31 female, 15 male) with newly diagnosed ESRD and iron deficieney anaemia were cnrolled into this study. The total need of iron of the patients was caiculated. The patients were taken to bicarbonate hemodialysis for two hours during six days. The first day, intravenous 25mg iron sucrose (Venofer®) vvas gİven to the patients as a test dose, the second day intravenous 1 OOmg was given in 30 minutes; after the second day 300mg/day were given unlil completc total iron deficit vvas replaced complefeiy. Haemoglobin (Hb), haematocrit (Hct), mcan corpuscular volumc (MCV), serum iron(Fc), serum iron binding capacİty (FeBC), trans-ferrin saturatİon (TS) and ferritin levels were studied before treatment and after four vveeks follovving treatment. The pretreatment levels of Hb, Hct, MCV, Fe, FeBC, TS and ferritin werc 7.6±0.6g/dl, 22.9±1.5%, 65±12fl, 28.6±12mcg/di, 378.6±39.8mcg/dl, 11.8±6.6%, 26.6±12.7ng/ml respeeti-vely. After four weeks they wcre 10.2±0.9g/dİ, 30.5+2.6%, 89.6+8fl, 68.6+24mcg/dl, 238.7+41 mcg/dl, 28.8±10.9%, 368.8+221ng/ml respeetively. The inereased mean levels of Hb, Hct, MCV, Fe, TS, ferritin and decreased serum level of FeBC were found as statistically significant (p<0.001). No side effect of the drııg was seen in the patients. The daily usagc of iron sucrose after hemodialysis session in patients wi(h newly diagnosed ESRD and iron deficieney was found to be safe and efficient.
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Abstract (Original Language): 
Son dönem böbrek yetmezliği (SDBY)'ndc görülen aneminin en önemli nedenlerinden biri de demir eksikliğidir ve tedavisinde standart bir yaklaşım mevcut değildir. Biz bu çalışmada yeni SDBY tanılı ve demir eksikliği anemili hastalarda İntravenöz demir sükroz kullanımının etkisini ve yan etkilerini araştırmayı amaçladık. Bu çalışmaya yeni SDBY tanısı konulan ve demir eksikliği tespit edilen 46 (31 kadm, 15 erkek) hasta alındı. Hastaların demir ihtiyacı hesaplandi. Hastalara altı gün boyunca her gün 2 saat bikarbonattı hemodiyaliz yapıldı. İlk gün demir sükroz (Venofer®) 25 mg intravenöz test dozu kontrollü olarak uygulandı, ikinci gün lOOmg intravenöz 30 dakikada verildi. İkinci günden sonra, total demir dozu tamamlanana kadar günde 300 mg demir sükroz verildi. Hastalanıl tedavi öncesinde vc tedavi tamamlandıktan 4 hafta sonra hemoglobin (Hb), hematokrit (Hct), ortalama eritrosit hacmi (OEH), serum demir (Fe), demir bağlama kapasitesi (FeBK), transferlin saturasyonu (TS) ve ferritin düzeyleri araştırıldı. Tedavi öncesi ortalama Hb, Hct, OEH, Fe, FeBK, TS ve ferritin düzeyleri sırasıyla 7.6±0.6g/dl, %22.9±1.5, 65±12fl, 28.6±12mcg/dl, 378.6±39.8mcg/dl, %li.8±6.6, 26.6±12.7ng/ml iken 4 hafta sonra sırasıyla 10.2+0.9g/dl, %30.5±2.6, 89.6±8fi, 68.6±24mcg/dl, 238.7±41mcg/dl, %28.8±10.9, 368.8+22lng/ml bulundu. Ortalama Hb, Hct, OEH, Fe, TS vc ferritin düzeylerindeki artış ve FeBK'deki düşüş istatistiksel olarak anlamlı bulundu (p<0.001). Hastaların hiçbirinde ilaca bağlı yan etki gözlenmedi. Yeni SDBY tanısı konulmuş ve demir eksikliği saptanmış olan hastalarda, günlük hemodiyaliz sonrası demir sükrozun İntravenöz olarak uygulanması güvenli ve etkili bulunmuştur
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REFERENCES

References: 

1. Andrews NC: Disorders of iron metabolism, "Blood, editörler: Handın RI, Lux SE, Stossel TP, Lippincott Willi¬ams and Wilkins, Philadelphia, 2. baskı (2002)" sayfa: 1400
2. Aylı M, Ayh D, Atalay V, Ensari C, Canbakan B, Adanalı S: Eriiropoetine dirençli renal aneminin tedavisinde intravenöz demir uygulaması. Türk Nefroloji Diyaliz ve Transplantasyon dergisi 10:49 (2001).
3. Cavill I: Diagnostic methods. Clin Haematol 2:259 (1982).
4. Chander N, Wozniak JS, Rodby R: The economic impact of inereased usage of intravenous iron dextran and sub-cutaneous erythropoieti» on the total cost of anemia treatment in hemodialysis patients. J Am Soc Nephrol 9:232A(1998).
5. Collins A, Ebben J, Ma J: Frequent i.v. iron dosing is as-socialcd with highcr infectious dcath. J Am Soc Nephrol 8:190A(1997).
6. Council on Food and Nutrition, Committee on iron Deficieney. iron deficieney in the United 2Stat.es. JAMA 203:119 (1968).
7. European best praetice guictelines for the management of anaemia in patients with ehronic renal failure. Nephrol Dial Transplant 14:1 (1999).
8. Fishbane S, Galgano C, Langley RC, Canfield W, Mae-saka JK: Reticulocyte hemoglobin content in the evahıa-tion of iron status of hemodialysis patients. Kidney Int 52:217 (1997).
9. Fishbane S, Ungureanu VD, Maeseka JK: The safety of İntravenous iron dextran in hemodialysis patients Am J Kidney Dis 28:529(1996).
10. Hamstra RD, Bİock MH, Schocket AL: intravenous iron dextran in clinical medicine. JAMA 242:1726 (1980).
11. Hörl HW, Cavill I, Macdougall IC, Schaefer RM, Suıı-der-PIassmann G: How to diagnose and con-ect iron deficieney during rHuEpo therapy. Nephrol Dial Transplant 11:246(1996).
Son Dönem Böbrek YetmezIİğindekİ Demir Eksikliği Anemisinin İntravenöz Demir Sükroz ile Tedavisi
12. Kosch M, Bahner U, Bettger H, Matzkies F, Teschner M, Schaefer RM: A randomized, controlled parallel-group trial on efficacy and safety of iron sucrose vs iron gluco-nate in hemodialysis patients treated with rHUEpo. Nephrol Dial Transplant 16:1239 (2001).
13. Lindsay RM, Burton JA, Edvvard N: Dialyzer blood İoss. Clin Nephrol 1:29(1973).
14. Longnecker RE, Giffînet JA, Hendİer ED: Bİood İoss du-ring maintenance hemodialysis. Trans Am Soc Artif In-tern Organs 20:135(1974).
15. Macdougall IC: Monitoring of iron status and iron supp-lementation in patients treated with erythropoietin. Curr Opin Nephrol Hypertens 3:620 (1994).
16. Macdougall IC, Chandler GC, Elston O, Harchowal J: Benefİcial effects of adopting an aggressive intravenous iron policy in a hemodialysis unit. Am J Kidney Dis 34 (suppl 2):40(1999).
17. Nissenson AR, Lindsay RM, Swan S, Seligman P, Stro-bos J: Sodium ferric gluconate complex is safe and effec-tİve in haemodiaiysis patients: North American clinicaİ trial. Am J Kidney Dis 33:471 (1999).
18. Pascual J, Temel JL, Liano F, Sureda A, Ortuna J: Serio-us adverse reactions after intravenous ferric gluconate. Nephrol Dial Transplant 7:271 (1992).
19. Roseniof K, Kiviwori SM, Granhagen RC, Teppo AM, Smiles MA: iron availability is transiently improved by intravenous iron medication in patients on chronic hemodialysis. Clin Nephrol 43:249 (1995).
20. Sakiev/icz P, Paganini E: The use of iron in patients on chronic dialysis: mistakes and misconceptions. J Nephrol 11:5 (1998).
21. Simva J, Andrade S, Vcntura H, Santos JPL, Colaço S, Oliverİa C, Ponce P: İron supplementation in haeınodi-alysis-practical clinicaİ guidelines. Nephroİ Dial Transplant 13:2572(1998).
22. Skorecki K, Grecn J, Brcnncr BM: Chronic renal failure, "Principles of internal medicine, editörler: Braunv/ald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, McGraw-HİİI, New York (2001)", sayfa: 1557.
23. Sunder PG, Hörl HW: iron metabolism and iron substitu-tion during erythropoietin therapy. Clin Invest 72:1 (1994).
24. Sunder-Plassmann G, Hörl WH: Safety of intravenous injection of iron saccharate in hemodialysis patients. Nephrol Dial Transplant 11: İ 797 (1996).
25. Sunder-Plassmann G, Hörl WH: Erythropoietin and iron. Clin Nephrol 47:141 (1997).
26. Sunder-Plassmann G, Hörl WH: Safety aspect of paren-teral iron in patients with end-stage renal disease. Drug Saf 17:241 (1997).
27. Van Wyck DB, Cavallo G, Spinowitz BS: Safety and efficacy of iron sucrose in patients sensitive to iron dext-ran: North American clinicaİ triai. Am J Kidney Dis 36:88 (2000).

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