scholarly journals Resorption and tolerance of the high doses of ferrous sulfate and ferrous gluconate in the patients on peritoneal dialysis

2006 ◽  
Vol 63 (2) ◽  
pp. 143-147 ◽  
Author(s):  
Mirjana Lausevic ◽  
Natasa Jovanovic ◽  
Svetlana Ignjatovic ◽  
Gordana Grujic-Adanja ◽  
Biljana Stojimirovic
Keyword(s):  
Peritoneal Dialysis ◽  
Side Effects ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Ferrous Sulphate ◽  
Oral Iron ◽  
Ferrous Gluconate ◽  
Elemental Iron ◽  
Significant Difference ◽  
High Doses

Background/Aim. Iron supplementation plays a crucial role in peritoneal dialysis (PD) patients. Oral iron substitution is more convenient than intravenous therapy in PD patients, but impaired absorption and adverse effects may be limiting factors for oral treatment. The aim of this study was to compare the absorption and side effects of high doses ferrous sulphate and ferrous gluconate in PD patients. Methods. Blood samples were taken from 29 PD patients at baseline, as well as 2, 4 and 8 hours after oral intake of 4 ferrous sulphate tablets (containing 105 mg elemental iron per tablet). The test was repeated using 8 ferrous gluconate drinkable ampoules (containing 50 mg elemental iron per ampoule). Results. The maximal increase in serum iron level during the test with iron sulphate was 113.51?103.37% versus the initial values of 183.87?37.38% during the ferrous gluconate test. The maximal values of serum iron after the intake of ferrous sulphate were 26.23?9.95 ?mol/l versus 30.97?8.65 ?mol/l after the intake of ferrous gluconate. There was a statistically significant difference between these two groups. Six patients showed an increase in serum iron of more than 300% after a high ferrous gluconate dose, while in 15 of the patients serum iron increased between 100% and 300%, and in 8 of the patients serum iron levels increased by less than 100%. Side effects occurred more frequently after the intake of ferrous sulphate than ferrous gluconate. Conclusion. High doses of oral iron were well absorbed and tolerated in PD patients. Ferrous gluconate was better absorbed and tolerated than ferrous sulphate, thus we recommend it for oral iron supplementation in PD patients.

scholarly journals Assessment of Gastrointestinal Symptoms and Non-transferrin Bound Iron After Oral Ferrous Sulfate and Iron-enriched Aspergillus Oryzae Supplementation in Women (P24-039-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Amanda Bries ◽  
Chong Wang ◽  
Brian Wels ◽  
Isaac Agbemafle ◽  
Olivia Meier ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Side Effects ◽  
Ferrous Sulfate ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Iron Supplements

Abstract Objectives Iron deficiency anemia (IDA) is a widespread nutritional deficiency. Iron supplementation with ferrous sulfate (FeSO4) is the most common strategy to treat IDA; however, the compliance with daily FeSO4 administration is poor, due to contraindicating side effects. Previously, we have reported that A. oryzae (Ultimine®; ULT) is a novel iron source. Therefore, the objective of this study was to determine the biochemical assessment, non-transferrin bound iron (NTBI) and commonly related gastrointestinal side effects to assess the safety of A. oryzae compared to FeSO4. Methods Female participants (n = 16) with serum ferritin concentrations 40 µg/L were randomized to a double-blind, 9-wk cross-over study with a 3-wk placebo washout period between treatments. Oral iron supplements (65 mg Fe), FeSO4 and ULT were administered for 21 consecutive days for each subject. Side effect questionnaires were collected 3d/wk over the 9-wk study period. Side effects and biochemical markers (nausea, heartburn, abdominal pain, fatigue, headache, diarrhea, constipation, oxidative stress and liver and kidney function) from iron supplementation were evaluated, along with serum iron, % transferrin saturation (TS) and NBTI 8 h curves. Results Serum iron, TS, and NTBI were all markedly higher with FeSO4 at each time-point from 2–8 hours (P < 0.001) compared to ULT, whereas NTBI was undetected. Among treatments, FeSO4 resulted in higher inflammation, though not statistically significant. Compliance based on returned pills was higher with ULT (97.3%) than placebo and FeSO4 (95.2% and 93.2%, respectively). Subjects taking FeSO4 reported abdominal discomfort 2% more than ULT, which was not significantly different. FeSO4 caused marginally higher incidence of combined nauseation, constipation and diarrhea when subjects were taking FeSO4 (P < 0.07). Iron status was maintained similarly by both oral iron supplements. Oxidative stress, inflammation, kidney and liver function markers were not elevated with ULT supplementation, suggesting safety of its consumption. Conclusions Better compliance and less gastrointestinal related side effects were reported with ULT compared to FeSO4, while maintaining normal iron status. Our data suggests ULT is a safe oral iron supplement for treatment of IDA. Funding Sources Cura Global Health, Inc.

scholarly journals Parenteral iron prophylaxis: a convenient alternative for antenatal women who do not consume oral iron

2017 ◽  
Vol 6 (9) ◽  
pp. 3832
Author(s):  
Suvarna Rai
Keyword(s):  
Side Effects ◽  
Iron Supplementation ◽  
Tertiary Care ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Tertiary Care Centre ◽  
Iron Administration ◽  
Significant Difference ◽  
Parenteral Iron

Background: A large number of antenatal women have difficulty consuming oral iron due to its well-known side effects. A simple alternative for it needs to be found. Aim and objective was to study the efficacy of parenteral iron prophylaxis as an alternative for antenatal women who are not able to consume oral iron.Methods: A prospective case control study was conducted at a tertiary care centre in Hyderabad city, India from March 2016- March 2017. 73 non-anemic antenatal women between 14-24 weeks who were not taking oral iron supplementation were identified. 39 of them were willing for parenteral iron supplementation were included in Cases group and 34 who were not taking iron supplementation in any form were controls. Cases were administered three doses of IV Iron sucrose 200mg in 100 ml normal saline between 24-28 weeks, 28 – 32 weeks and 35-37 weeks Hemoglobin was checked again at 32weeks, 36 weeks, just prior to and on 3rd day post-delivery. Data obtained was analyzed using SPSS software.Results: 67% of antenatal women discontinued oral iron due to its gastric side effects. No bias took place during selection of cases and controls. 7.69% of the ‘cases group’ developed anemia despite parenteral prophylaxis. All of them were diagnosed as mild anemia. 70.59% of the ‘controls group’ developed anemia eventually of which 8 were mild, 13 were moderate, 3 were severe and none were very severe. Mostly women became anemic after delivery. About 59% of antenatal women in cases group had no adverse effects with Iron Sucrose Injections, 8 of them had itching or rash and 9 of them complained of brownish discoloration of urine.11 of them had pain at the infusion site and only 1 of them had fever on administering parenteral therapy. None of these were severe enough to cause discontinuation of parenteral iron administration. No statistically significant difference could be found in maternal and perinatal morbidity and mortality between the two groups. The mean cost of parenteral iron prophylaxis was Rs. 1650.Conclusions: Women who do not take oral Iron supplementation in pregnancy are more prone to develop anemia subsequently. The commonest cause of non-compliance to oral iron is gastric intolerance. 3 doses of Intravenous Iron Sucrose 200mg prevents anemia in antenatal women who do not take oral iron supplementation. Hence, it can now be considered a convenient option for them.

scholarly journals Oral Iron Supplementation—Gastrointestinal Side Effects and the Impact on the Gut Microbiota

2021 ◽  
Vol 12 (2) ◽  
pp. 491-502
Author(s):  
Sarah R. Bloor ◽  
Rudolph Schutte ◽  
Anthony R. Hobson
Keyword(s):  
Side Effects ◽  
Gut Microbiota ◽  
Iron Supplementation ◽  
Methanogenic Archaea ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Intestinal Lumen ◽  
Gastrointestinal Side Effects ◽  
Potential Link ◽  
The Impact

Iron deficiency anaemia (IDA) is a worldwide healthcare problem affecting approximately 25% of the global population. The most common IDA treatment is oral iron supplementation, which has been associated with gastrointestinal (GI) side effects such as constipation and bloating. These can result in treatment non-adherence and the persistence of IDA. Intravenous iron does not cause GI side effects, which may be due to the lack of exposure to the intestinal lumen. Luminal iron can cause changes to the gut microbiota, aiding the promotion of pathogenic species and decreasing beneficial protective species. Iron is vital for methanogenic archaea, which rely on iron for growth and metabolism. Increased intestinal methane has been associated with slowing of intestinal transit, constipation, and bloating. Here we explore the literature to understand a potential link between iron and methanogenesis as a novel way to understand the mechanism of oral iron supplementation induced GI side effects.

scholarly journals Intravenous infusion of total dose iron is superior to oral iron in treatment of anemia in peritoneal dialysis patients: a single center comparative study.

1998 ◽  
Vol 9 (4) ◽  
pp. 664-668 ◽  
Author(s):  
N Ahsan
Keyword(s):  
Peritoneal Dialysis ◽  
Total Dose ◽  
Intravenous Infusion ◽  
Iron Supplementation ◽  
Transferrin Saturation ◽  
Intravenous Iron ◽  
Outpatient Setting ◽  
Oral Iron ◽  
Human Erythropoietin ◽  
Oral Group

In the treatment of anemia of chronic renal failure, the most common cause of recombinant human erythropoietin (rhEPO) resistance is iron deficiency. In peritoneal dialysis (PD) patients, oral iron therapy is an accepted and convenient method of iron supplementation. The effectiveness of oral iron, however, is limited by many factors, including gastrointestinal side effects and poor gastric absorption. This study prospectively compared the efficacy of single intravenous infusion of total dose iron (ITDI group) given in an outpatient setting with oral iron (oral group) for the treatment of anemia in PD patients. Twenty-five adult stable PD patients with baseline hematocrit 25 to 35% were entered into the study. Thirteen patients with serum transferrin saturation (TSAT) < 25% received ITDI, and 12 patients with TSAT between 25 and 35% received oral iron. One patient in the oral group received emergent blood transfusion and was excluded from analysis. Hematocrit and iron indices were measured at monthly intervals. Doses of rhEPO were adjusted monthly to maintain target hematocrit at 35%. At the end of the study (6 mo), despite similar baseline mean hematocrit (31.0 +/- 0.9 versus 33.0 +/- 1.0%), comparable mean baseline weekly rhEPO dose (7886 +/- 1449 versus 6370 +/- 1553 U/wk), and significantly lower level of mean TSAT (11.3 +/- 3.5 versus 30.1 +/- 3.5%; P < 0.05), the ITDI group when compared with the oral group had significantly higher mean hematocrit (36.0 +/- 1.0 versus 31.4 +/- 1.1%; P < 0.05) and TSAT (33.7 +/- 3.7 versus 22.6 +/- 4.0%; P < 0.05) values. In addition, the final mean dose of weekly rhEPO was significantly lower in the ITDI group (4799 +/- 981 versus 9998 +/- 1027 U/wk; P < 0.05). No patient in the ITDI group developed an adverse reaction to intravenous iron. It is concluded that ITDI represents a more efficacious method of iron supplementation in PD patients receiving rhEPO. Moreover, ITDI is safe and well tolerated and can be administered in an outpatient setting.

scholarly journals Anemia in peritoneal dialysis patients

2006 ◽  
Vol 134 (3-4) ◽  
pp. 133-137 ◽  
Author(s):  
Mirjana Lausevic ◽  
Vidosava Nesic ◽  
Natasa Jovanovic ◽  
Biljana Stojimirovic
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Count ◽  
Iron Supplementation ◽  
Transferrin Saturation ◽  
Recombinant Erythropoietin ◽  
Dialysis Patients ◽  
Human Recombinant Erythropoietin ◽  
Iron Stores ◽  
Number Of Patients ◽  
Significant Difference

A normocytic normochromic anemia is one of the first signs of renal failure. Since anemia increases morbidity and mortality, its elimination is one of the essential objectives of the treatment. Human recombinant erythropoietin (rHuEPO) has changed the therapeutical approach to anemia. The aim of the present study was to compare efficacy of anemia correction in peritoneal dialysis patients depending on treatment and dialysis modality. The study is the retrospective analysis of 64 patients who presented to our Clinic in 2003. Eighteen (28.13%) patients were treated with rHuEPO, 14 (28%) underwent continuous ambulatory peritoneal dialysis (CAPD), 2 (100%) - automated peritoneal dialysis (APD) and 2 (33.3%) - intermittent peritoneal dialysis (IPD). Mean hemoglobin level was 98.6?17.82 g/l in patients treated with rHuEPO versus 98.81?15.14 g/I in patients without rHuEPO treatment. Erythropoietin requirements were 3392.85?1211.77 IU/week. AII patients received iron supplementation during rHuEPO therapy. Mean serum ferritin levels were 463.41 ?360 ?g/l. Transferrin saturation (TSAT) was 0.35?0.16%. No difference of serum iron and TSAT levels was found between CAPD and IPD patients. The degree of anemia significantly differed between CAPD and IPD patients. A total of 17.11% of PD patients were given blood transfusions, most frequently during the first three months after the onset of dialysis. Our conclusion is that the number of patients receiving rHuEPO should be increased, as 50% of our patients should be substituted, while only 28% are being treated. As 50% of patients receiving rHuEPO failed to reach target Hgb levels, higher EPO doses should be considered. Iron stores should be continuously monitored, particularly in patients receiving rHuEPO, since iron deficiency is an important problem for patients undergoing peritoneal dialysis, especially during erythropoietin therapy. Oral iron supplementation is satisfactory in the majority of patients, and iron-gluconate is absorbed better than iron-sulphate. If required, intra-venous iron bolus is safe and efficient. Continuous peritoneal dialysis treatment improves blood count more effectively compared to intermittent procedures, as hemoglobin levels are significantly higher in patients with comparable iron stores. Peritoneal dialysis is particularly efficient in improving the blood count in diabetics, since no significant difference of anemia between patients affected by diabetes mellitus and the others could be found in our study.

scholarly journals Intravenous versus oral iron therapy in treatment of postpartum anaemia

2017 ◽  
Vol 6 (8) ◽  
pp. 3454
Author(s):  
Neelima Agarwal ◽  
Preeti Sharma
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Ferrous Sulphate ◽  
Intravenous Iron ◽  
Hemoglobin Level ◽  
Oral Iron ◽  
Chi Square ◽  
Deficiency Anaemia ◽  
Significant Difference ◽  
Red Cell Indices

Background: Postpartum iron deficiency anaemia (IDA) is common in women. Most women are treated with either oral iron supplementation or blood transfusion. Hence, the aim of our study was to compare the effect of treatment with either oral ferrous sulphate or intravenous ferrous sucrose on postpartum IDA.Methods: 100 postpartum women with proven iron deficiency anaemia with hemoglobin <9gm/dl and serum ferritin <15 µgm/l were included in the study. They were randomized to receive either oral ferrous sulphate 200 mg twice daily for 6 weeks (group 1) or intravenous ferrous sucrose 200 mg, two to three doses given on alternate days (group 2). Total iron deficit was calculated using a standard formula. Target hemoglobin was 11 gm/dl. Results were analysed by the students t-test and chi-square test. Hemoglobin, hematocrit, red cell indices and ferritin were measured on day 2-3, 1-2 weeks and 6 weeks postpartumResults: By 1-2 weeks, hemoglobin level in women treated with intravenous iron had risen from 7.81±0.849 to 9.88±0.760 gm/dl which was more than those treated with oral iron (p<0.01); although by 6 weeks, there was no significant difference between the two groups. Ferritin levels rose rapidly in those treated with intravenous iron and remained significantly higher than in those treated with oral iron (p<0.01).Conclusions: Intravenous iron sucrose increases the hemoglobin level more rapidly than oral ferrous sulphate in women with postpartum IDA. It also replenishes iron stores more rapidly. 

Novel Iron-Whey Protein Microspheres Protect Gut Epithelial Cells from Iron-Related Oxidative Stress and Damage and Improve Iron Absorption in Fasting Adults

2017 ◽  
Vol 138 (4) ◽  
pp. 223-232 ◽  
Author(s):  
Jun Wang ◽  
Gabor Radics ◽  
Michael Whelehan ◽  
Aoibhe OʼDriscoll ◽  
Anne Marie Healy ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Whey Protein ◽  
Serum Iron ◽  
Iron Absorption ◽  
Ferrous Sulphate ◽  
Oral Iron ◽  
High Dose ◽  
Food Fortification ◽  
Iron Depletion ◽  
Baseline Serum

Background: Iron food fortification and oral iron formulations are frequently limited by poor absorption, resulting in the widespread use of high-dose oral iron, which is poorly tolerated. Methods: We evaluated novel iron-denatured whey protein (Iron-WP) microspheres on reactive oxygen species (ROS) and viability in gut epithelial (HT29) cells. We compared iron absorption from Iron-WP versus equimolar-dose (25 mg elemental iron) ferrous sulphate (FeSO4) in a prospective, randomised, cross-over study in fasting volunteers (n = 21 per group) dependent on relative iron depletion (a ferritin level ≤/>30 ng/mL). Results: Iron-WP caused less ROS generation and better HT29 cell viability than equimolar FeSO4. Iron-WP also showed better absorption with a maximal 149 ± 39% increase in serum iron compared to 65 ± 14% for FeSO4 (p = 0.01). The response to both treatments was dependent on relative iron depletion, and multi-variable analysis showed that better absorption with Iron-WP was independent of baseline serum iron, ferritin, transferrin saturation, and haemoglobin in the overall group and in the sub-cohort with relative iron depletion at baseline (p < 0.01). Conclusions: Novel Iron-WP microspheres may protect gut epithelial cells and improve the absorption of iron versus FeSO4. Further evaluation of this approach to food fortification and supplementation with iron is warranted.

Anemia as a Complication of Bariatric Surgery: Frequency and Evidence for Progressive Negative Iron Balance.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1721-1721
Author(s):  
Annette von Drygalski ◽  
Deborah A. Andris ◽  
Scott Jackson ◽  
Peter R. Nuttleman ◽  
J. Klein ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Iron Deficiency ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Binding Capacity ◽  
Oral Iron ◽  
The Us ◽  
The Mean ◽  
And Gender ◽  
Folate And Vitamin B12

Abstract Bariatric surgery has become an important means to reduce obesity and its related morbidity. Bariatric surgeries in the US have increased from 14,000 in 1998 to 140,000 in 2004. Malabsorption and achlorhydria can complicate bariatric surgery and may lead to iron deficiency and anemia. In this setting, little is known about the prevalence and severity of anemia and the efficacy of oral iron replacement, a common part of post-surgical management. We reviewed the records at our institution of a large number (n=1125; 126 men; 999 women) of patients followed for up to 4 yrs post-procedure for the development of anemia and assessment of vitamin levels and iron stores. METHODS: Body mass index (BMI), hemoglobin (Hb), B12, folate, serum iron and ferritin values were extracted from electronic records of the patients at baseline, and 250 patients (33 men; 217 women) followed out to 4 yrs after Roux-en-Y gastric bypass. Anemia was defined by age- and gender-specific WHO criteria. RESULTS: Mean BMI fell from 50.1 (CI 49.6–50.6) at baseline to 33.1 (CI 29.8–36.4) at 4 yrs. Anemia was present in 12% of all patients at baseline and was similar between men (9%) and women (12%). At 18mos, 29% of woman &lt;50yrs of age were anemic, compared to 9% of women &gt;50 yrs (p=0.02). For patients followed out to 2–4 yrs, 21% were anemic and women &lt;50 yrs were most affected (29%) compared to women &gt;50 yrs (15%; p=0.02). The incidence of anemia among men did not change over the period of observation. In all patients the mean Hb decreased from 13.4 g/dL (CI 13.3–13.5) at baseline to 12.1 g/dL (CI 11.1–13.1; p&lt;0.05) at 4yrs. Mean Hb in anemics was 10.4 g/dL. Baseline ferritin was 87 ng/mL (CI 75.2–99.7) for all patients and fell to 66 ng/mL(CI 51.2–80.0) at 18mos and 55 ng/mL (CI 43.3–66.2) by 2–4yrs. The percent of patients with ferritins &lt;50 and &lt;20 ng/mL at baseline were 23 and 11, respectively, and, of these, 15 and 25% were anemic. By yr 4, the percent of patients with ferritins &lt;50 ng/mL rose to 66 and 21% were anemic; the percent with ferritin &lt;20 was 4% and 33% were anemic. Again, women &lt;50 yrs were most at risk with a mean ferritin of 35 ng/mL (CI 21.8–48.2); of these 5% had a ferritin &lt;20 ng/mL and 37% of those were anemic. Of women &gt; 50 years, the mean ferritin was 63 ng/mL (CI 45.3–80.5); 54% had ferritins &lt;50 ng/mL and, of these, only 15% were anemic (p=0.04). Of the 4% with a ferritin &lt;20 ng/mL, 25% were anemic. Mean B12 and folate levels remained stable and did not correlate with anemia. In contrast to ferritin, mean serum iron values did not decrease. Interpretation of this finding is difficult since total iron binding capacity was not measured simultaneously and supplemental iron intake might be confounding. CONCLUSIONS: although oral iron, folate and vitamin B12 supplements were routinely prescribed after surgery, anemia was a common complication and its frequency increased with time. Negative iron balance was progressive, despite oral iron supplementation. While iron deficiency did not account for all cases of anemia, it is sufficiently common to warrant careful evaluation of the ability of bariatric patients to absorb iron and/or comply with life-long oral iron supplementation. Given the rapidly increasing number of bariatric procedures in the US, all physicians should be alerted to the possible need for parenteral iron therapy to prevent anemia and its complications.

1001 Intravenous Ferric Carboxymaltose For Restless Legs Syndrome In Children And Adolescents

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A380-A380
Author(s):  
L M DelRosso ◽  
R Ferri ◽  
R P Allen ◽  
M L Chen ◽  
S Kotagal ◽  
...  
Keyword(s):  
Side Effects ◽  
Children And Adolescents ◽  
Serum Ferritin ◽  
Restless Legs Syndrome ◽  
Iron Supplementation ◽  
Oral Iron ◽  
Ferric Carboxymaltose ◽  
Chi Square ◽  
Restless Legs ◽  
Post Infusion

Abstract Introduction Substantial scientific evidence implicates brain iron deficiency in the pathophysiology of restless legs syndrome (RLS). Current clinical guidelines recommend oral and intravenous iron (IV) in the treatment of both adult and pediatric RLS but studies using ferric carboxymaltose (FCM) are lacking in children and adolescents. Methods Retrospective case series of children and adolescents with RLS treated with IV FCM who had serum ferritin levels &lt;50 μg/L. Patients were offered a single dose of IV FCM, 15 mg/kg if weighting &lt;50 kg or 750 mg if weighting &gt;50 kg. Iron profile, serum ferritin, and severity assessment by the International Restless Legs Study Group severity scale (IRLS) were collected pre- and post-infusion. Clinical Global Impression Scale (CGI) was used instead of the IRLS for children. Phosphorus level and adverse effects were assessed post-infusion in all patients. Age and sex-matched children with RLS treated with oral iron supplementation (mean dosage 1.5±0.62 mg/kg/day) were included as a comparison group. Results Twenty-eight subjects (15 females, mean age 11.5 years, SD 4.23) and 24 controls were included. Baseline ferritin levels were not significantly different from those of controls but increased significantly from 13.9±7.02 to 112.9±12.00 μg/L after 8 weeks from infusion (p&lt;0.000001), when they were also significantly higher than control values (34.2±21.64 μg/mL, p&lt;0.000001). Transferrin saturation increased from 22.8±9.77% to 31.7±6.81% (p&lt;0.0001), total iron binding capacity decreased from 366.7±51.32 to 302.0±37.83 μg/dL (p&lt;0.0000035). RLS was reported to be resolved or improved in all children treated with IV iron (vs. 62.5% of controls) while none of them reported no change (vs. 37.5% of controls; Chi-square test 9.84, p&lt;0.002). IRLS Score decreased in adolescents from 30.7±22.68 to 3.2±4.21 (p&lt;0.000008) while CGI-I was “very much improved” in six children and “much improved” in four. Side effects were reported in 17.8% of patients treated IV and 20.8% controls (Chi-square 0.0169, p=0.897). FCM side effects included lightheadedness and gastrointestinal discomfort. Post IV phosphorus levels were normal in all participants. Conclusion This open-label, observational and retrospective study indicates that FCM IV infusion is an effective treatment for pediatric RLS with higher efficacy than oral iron supplementation. Support  

Oral Administration of Ferrous Sulfate, but not of Iron Polymaltose or Sodium Iron Ethylenediaminetetraacetic Acid (NaFeEDTA), Results in a Substantial Increase of Non-Transferrin-Bound Iron in Healthy Iron-Adequate Men

2012 ◽  
Vol 33 (2) ◽  
pp. 128-136 ◽  
Author(s):  
Klaus Schümann ◽  
Noel W. Solomons ◽  
Maria-Eugenia Romero-Abal ◽  
Monica Orozco ◽  
Guenter Weiss ◽  
...  
Keyword(s):  
Oral Administration ◽  
Ferrous Sulfate ◽  
Serum Iron ◽  
Iron Supplementation ◽  
Ethylenediaminetetraacetic Acid ◽  
Iron Concentration ◽  
Oral Iron ◽  
Plain Water ◽  
Iron Compounds ◽  
Competitive Binding Assay

Background Oral iron supplementation with ferrous sulfate (FeSO4) at dosage levels suggested by the international guidelines poses a safety hazard to young children with malaria. Exposure to loosely bound iron in the circulation has been advanced as a potential factor. Objective To evaluate the kinetics of circulating concentrations of plasma iron and non-transferrin-bound iron (NTBI) in response to oral iron administration in healthy adults. Methods Plasma samples were collected at 90-minute intervals over a period of 270 minutes from 10 healthy Guatemalan men after oral administration of water or 100 mg of iron from each of three iron compounds: FeSO4, sodium iron ethylenediaminetetraacetic acid (NaFeEDTA), and iron polymaltose. The four tests were administered in an individually randomized sequence. Serum iron concentration was measured spectrophotometrically by the ferrozine method, and NTBI concentration was measured by a fluorometric competitive binding assay. The kinetic response and the maximal and cumulative changes in circulating concentrations of the biomarkers of interest were compared. Results Serum iron and NTBI responses to oral administration of FeSO4 were significantly greater than responses to plain water or the other two iron compounds. NTBI concentrations after NaFeEDTA or iron polymaltose ingestion were not different from those determined after water intake. Conclusions Administration of two iron compounds of proven bioavailability, but with complex absorption characteristics, is associated with a negligible NTBI response, potentially mitigating the safety concerns associated with iron supplementation in malarial areas.

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