Iron Products
Iron salts are nutritionally essential inorganic substances used to treat anemia.
Ferrous sulfate (Feosol, Fer-In-Sol, Slow FE, Fer-iron, MyKidz Iron 10)
Ferrous sulfate is used as a building block for hemoglobin synthesis in patients with anemia of CKD who are being treated with erythropoietin.
Iron dextran complex (Dexferrum, INFed)
Iron dextran is used to treat microcytic, hypochromic anemia resulting from iron deficiency, and to replenish iron stores in individuals on erythropoietin therapy, when oral administration is infeasible or ineffective. A 0.5-mL (0.25 mL in children) test dose should be administered prior to starting therapy. This agent is available as 50 mg iron/mL (as dextran).
Iron sucrose (Venofer)
Iron sucrose is used to treat iron deficiency anemia (in conjunction with erythropoietin) in patients with dialysis- and non–dialysis-dependent CKD. Iron deficiency in these patients is caused by blood loss during the dialysis procedure, increased erythropoiesis, and insufficient absorption of iron from the gastrointestinal tract. There is a lower incidence of anaphylaxis with iron sucrose than with other parenteral iron products.
Ferric gluconate (Ferrlecit, Nulecit)
Ferric gluconate replaces the iron found in hemoglobin, myoglobin, and specific enzyme systems, allowing transportation of oxygen via hemoglobin.
Ferumoxytol (Feraheme)
Ferumoxytol is indicated for iron replacement in adults with CKD who have iron deficiency anemia. Iron is released from an iron-carbohydrate complex in reticuloendothelial system macrophages. The released iron is transported into storage pools or plasma transferrin, which allows the iron to be incorporated into hemoglobin.
Ferric pyrophosphate (Triferic)
Contains iron in the form of soluble ferric pyrophosphate citrate that is added to hemodialysate solution and administered to patients by transfer across the dialyzer membrane. Iron delivered into the circulation binds to transferrin for transport to erythroid precursor cells to be incorporated into hemoglobin.
Ferric carboxymaltose (Injectafer)
Ferric carboxymaltose is a non-dextran IV colloidal iron hydroxide in complex with carboxymaltose, a carbohydrate polymer that releases iron. It is indicated for iron deficiency anemia (IDA) in adults who have intolerance or an unsatisfactory response to oral iron. It is also indicated for IDA in adults with nondialysis- dependent chronic kidney disease.
Related Questions:
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Calciphylaxis due to secondary hyperparathyroidism.
Tables
Pradeep Arora, MD Assistant Professor of Medicine, University of Buffalo State University of New York School of Medicine and Biomedical Sciences; Attending Nephrologist, Veterans Affairs Western New York Healthcare System
Disclosure: Nothing to disclose.
Vecihi Batuman, MD, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Interim Chair, Deming Department of Medicine, Tulane University School of Medicine
Vecihi Batuman, MD, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, International Society of Nephrology, Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.
George R Aronoff, MD Director, Professor, Departments of Internal Medicine and Pharmacology, Section of Nephrology, Kidney Disease Program, University of Louisville School of Medicine
George R Aronoff, MD is a member of the following medical societies: American Federation for Medical Research, American Society of Nephrology, Kentucky Medical Association, and National Kidney Foundation
Disclosure: Nothing to disclose.
Laura Lyngby Mulloy, DO, FACP Professor of Medicine, Chief, Section of Nephrology, Hypertension, and Transplantation Medicine, Glover/Mealing Eminent Scholar Chair in Immunology, Medical College of Georgia
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Medscape Salary Employment
Mauro Verrelli, MD, FRCP(C), FACP Assistant Professor, Department of Medicine, Section of Nephrology, University of Manitoba, Canada
Disclosure: Nothing to disclose.