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2015 ; 26
(11
): 2612-9
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The Labile Side of Iron Supplementation in CKD
#MMPMID25999405
Slotki I
; Cabantchik ZI
J Am Soc Nephrol
2015[Nov]; 26
(11
): 2612-9
PMID25999405
show ga
The practice of intravenous iron supplementation has grown as nephrologists have
gradually moved away from the liberal use of erythropoiesis-stimulating agents as
the main treatment for the anemia of CKD. This approach, together with the
introduction of large-dose iron preparations, raises the future specter of
inadvertent iatrogenic iron toxicity. Concerns have been raised in original
studies and reviews about cardiac complications and severe infections that result
from long-term intravenous iron supplementation. Regarding the iron preparations
specifically, even though all the currently available preparations appear to be
relatively safe in the short term, little is known regarding their long-term
safety. In this review we summarize current knowledge of iron metabolism with an
emphasis on the sources and potentially harmful effects of labile iron, highlight
the approaches to identifying labile iron in pharmaceutical preparations and body
fluids and its potential toxic role as a pathogenic factor in the complications
of CKD, and propose methods for its early detection in at-risk patients.
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