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This study was conducted to compare effects of dietary administration of iron dextran and bacterial-iron on growth performance, fecal microbial flora, and blood profiles in sows and their litters. A total of 20 multiparous sows ( Landrace × Yorkshire) were randomly allotted into two treatments: (i) ID (basal diet, piglets were injected with iron dextran); (ii) BR (basal diet + bacterial-iron; bacterial-iron was given to sows, piglets were not injected with iron dextran). There were five replicates per treatment with two sows per replicate. No differences were observed on sow and piglet growth performance, fecal microbial flora as well as sow blood profiles between ID and BR treatments. In piglets, blood iron, red blood cell and hemoglobin concentrations in ID treatment were higher ( P < 0.05) on days 12 and 24. Furthermore, concentration of white blood cells in BR treatment was lower ( P < 0.05) on day 12. However, the percentage of lymphocytes on day 12 was increased ( P < 0.05) in BR treatment. In conclusion, effect of iron dextran and bacterial-iron has no difference on growth performance in lactating sows and piglets, but iron dextran injection has higher blood iron, white blood cell, red blood cell and hemoglobin concentrations in piglets. [ABSTRACT FROM AUTHOR]

Intravenous iron dextran is widely used in hemodialysis patients receiving erythropoietin (EPO) therapy because of its significant convenience in clinical practice. However, the amount of iron removed by hemodialysis in vivo is unknown. The purpose of this study was to measure the removal of iron dextran in patients undergoing hemodialysis. Six patients were enrolled in this study. All were stable patients treated by hemodialysis for at least 1 month. Both F6 (polysulphone membrane) and GFSplus12 (hemophane membrane) dialyzers were used sequentially in each patient. Each patient received 2 mL of low-molecular-weight iron dextran (Cosmofer® aktieselskab/aksjeselskap and supplied by Zhuhai Schwarz Pharma Company Ltd) intravenously, containing 100 mg of elemental iron, administered during the second hour of dialysis over 30 to 60 minutes. A baseline sample of fresh dialysate was collected before the commencement of dialysis. A control sample of spent dialysate was collected during the first hour of dialysis, before the infusion of low-molecular-weight iron dextran. Then, all spent dialysate after the iron dextran infusion until the end of dialysis was collected. The samples were treated with lanthanum nitrate solution, and the iron content was measured using an atomic-absorptive spectrum method. The iron concentration in the control group was 4.31 ± 2.55 µg/L. After the infusion of iron dextran, the iron concentration in the spent dialysate increased significantly, irrespective of whether an F6 or GFSplus12 dialyzer was used. However, the amount of iron eliminated through the dialyzer was minimal, less than 3% of the infusion dose. There was no significant difference in removal of iron through either the F6 or GFSplus12 dialyzer. These results indicate that the removal of iron dextran by hemodialysis when using either a polysulfphone or hemophane membrane dialyzer is negligible. It is time-efficient and convenient to administer low-molecular-weight iron dextran during hemodialysis. [ABSTRACT FROM AUTHOR]

Anemia in peritoneal dialysis (PD) is related to impaired erythropoiesis and/or iron deficiency. Oral iron is insufficient to supply adequate accessible iron to patients with end-stage renal failure. Intermittent intravenous (IV) iron supplementation is effective but inconvenient in PD patients. Intraperitoneal (IP) iron may present a more convenient method of administration. In this study, we examined the efficacy of IP iron dextran in comparison with IV iron. Prospective randomized and crossover studies were carried out. Patients with a serum ferritin less than 200 µg/L, with no contraindications, were randomized to receive either IP or IV iron. Patients randomized to IP iron were subsequently crossed over to receive IV iron. Analysis using the t-test and Mann–Whitney U test of 16 patients (12 IP and 15 IV) was performed. IP iron did not produce an increase in storage or utilizable iron in PD patients. Hemoglobin (Hb) concentrations and erythropoietin (EPO) dose were unaffected. IV iron produced a significant increase in both circulating and storage iron, with a significant rise in Hb concentrations and no change in EPO requirements. No adverse events occurred after a total of 81 doses of iron therapy. These data suggest that IP iron in this group of patients offers no clinical efficacy in PD patients. [ABSTRACT FROM AUTHOR]

Intravenous iron administration is an effective method of treating iron deficiency anemia, but there have been concerns about adverse side effects, particularly serious events such as anaphylactic reaction. Several different forms of intravenous iron are available, but few studies have attempted to compare the frequency of adverse events. We carried out a systematic review to assess the frequency of adverse drug events (ADEs) associated with (i) low-molecular-weight intravenous iron dextran and (ii) iron sucrose. We searched several electronic databases; two reviewers screened all studies identified and extracted data. We included 60 studies, but few directly compared adverse events associated with two or more forms of iron, and most were not specifically designed to evaluate adverse events. In general, with the exception of high-molecular-weight iron dextran (HMWID), serious or life-threatening adverse events appeared rare. Several studies showed lower risks of ADEs on low-molecular-weight iron dextran (LMWID) compared with HMWID, and one large review found a reduced risk on LMWID compared with iron gluconate. Two studies showed little difference between iron sucrose and iron gluconate, and two further studies had similar rates of adverse drug events between iron sucrose and LMWID; however, the sample size for most of these studies was too small to draw firm conclusions. Adequately powered direct comparisons of different forms of intravenous iron are required to assess the safety profiles. [ABSTRACT FROM AUTHOR]

Study Objective. To compare non-transferrin-bound iron and markers of oxidative stress after single intravenous doses of iron dextran, sodium ferric gluconate, and iron sucrose. Design. Prospective, open-label, crossover study. Setting. University-affiliated general clinical research center. Patients. Twelve ambulatory patients undergoing hemodialysis. Intervention. Patients received 100 mg of intravenous iron dextran, sodium ferric gluconate, and iron sucrose in random sequence, with a 2-week washout period between treatments. Measurements and Main Results. Serum samples for transferrin saturation, non-transferrin-bound iron, and malondialdehyde (MDA; marker of lipid peroxidation) were obtained before (baseline) and 30, 60, 120, and 3(,0 minutes and 2 weeks after each iron infusion. A serum sample for heme-oxygenase-1 (HO-1) RNA was obtained at baseline and 360 minutes after infusion. Non-transferrin-bound iron values were significantly higher 30 minutes after administration of sodium ferric gluconate and iron sucrose compared with iron dextran (mean ± SEM 10.1 ± 2.2, 3.8 ± 0.8, and 0.23 ± 0.1 µM, respectively, p<0.001 for sodium ferric gluconate vs iron dextran, p=0.002 for iron sucrose vs iron dextran). A significant positive correlation was noted between transferrin saturation and the presence of non-transferrin-bound iron for sodium ferric gluconate and iron sucrose (r²=0.37 and 0.45, respectively, p<0.001) but not for iron dextran (r² = 0.09). After sodium ferric gluconate, significantly more samples showed increases in MDA levels from baseline compared with iron sucrose and iron dextran (p=0.006); these increased levels were associated with the presence of non-transferrin-bound iron, baseline transferrin saturation above 30%, baseline transferrin levels below 180 mg/dl, and ferritin levels above 500 ng/ml (p<0.05). However, only a transferrin level below 180 mg/dl was independently associated (odds ratio 4.8, 95% confidence interval 1.2-15.3). Conclusion. Iron sucrose and sodium ferric gluconate were associated with greater non-transferrin-bound iron appearance compared with iron dextran. However, only sodium ferric gluconate showed significant increases in lipid peroxidation. The relationship between non-transferrin-bound iron from intravenous iron and oxidative stress warrants further exploration. [ABSTRACT FROM AUTHOR]

A 67-year-old woman with iron deficiency anemia required parenteral iron therapy and was treated with intravenous ferric gluconate. She tolerated the first dose, but after the second dose, she developed a tingling feeling all over her body, along with swelling in her hands and feet, and a rash with hives over most of her body. It was thought that she had likely experienced a hypersensitivity reaction to ferric gluconate. The decision was made to continue therapy; however, two modifications were made. The patient was given dexamethasone, diphenhydramine, and ibuprofen 1 hour before administering the third dose, and the infusion time was prolonged by 1 hour. Approximately 45 minutes after the infusion was completed, the patient developed hives on her arms and legs. At the patient's next clinic visit, it was decided that continuation of parenteral iron repletion was necessary, and the decision was made to attempt a challenge with iron sucrose. The patient was given dexamethasone 8 mg to be taken the night before and the morning of treatment. She successfully completed the iron repletion therapy with iron sucrose. Three parenteral iron products are available in the United States: iron dextran, sodium ferric gluconate complex, and iron sucrose. Iron dextran, the oldest of these products, carries the highest risk for hypersensitivity reactions. Available data suggest that either iron sucrose or ferric gluconate can he safely administered to patients with known hypersensitivity to iron dextran. Our patient's experience implies that it may be possible to safely administer iron sucrose to a patient with hypersensitivity to ferric gluconate. This finding has clinical implications and warrants confirmation in a larger population. [ABSTRACT FROM AUTHOR]