DIFFICULTIES IN VERIFYING THE CAUSES OF IRON-DEFICIENCY ANAEMIA REFRACTORY TO ADEQUATELY ADMINISTERED THERAPY WITH IRON SUPPLEMENTS

Diseases of the gastrointestinal tract (GIT) are one of the reasons for the development of iron deficiency anemia (IDA). The presence of gastroenterological pathology often leads to the refracterity of anemia to standard therapy, which necessitates timely diagnosis and adequate correction of background disease. A rare variant of anemia refractory to ferrotherapy is iron-refractory IDA (IRIDA), whose genesis contains an iron exchange disorder caused by a mutation in the TMPRSS6 gene. The article discusses the differential diagnostic spectrum of GIT diseases as potential causes of anemia, examines the pathogenetic mechanisms of IRIDA in a clinical trial, which required the elimination of a genetically deterministic iron exchange disorder at the diagnostic stage.

Iron metabolismin conditions of infection. Review

The purpose of writing the review. Analysis of publications on the role of iron metabolism in the manifestation of the septic process and the dependence of bacterial flora activity on the conditions of their access to iron. Methods. More than 200 publications in pubmed, Medline, EMBASE medical literature databases were analyzed between 2000 and 2018 using the search words: iron and infection, iron and sepsis, iron exchange, iron and bacteria - including and available works in domestic (e-library) literature. Results. The review uses materials from 61 publications that meet the challenges of the search and reflect both the relationship between iron exchange and the development of the septic process and the importance for the medical community of understanding the identified relationships in the search for future therapeutic approaches. Conclusion. The review provides evidence of direct iron involvement in the manifestation of the septic process caused by various bacterial (q/-) and fungal flora. Introduction of iron-hesing agents and ciderophon - conjugate drugs to infected patients today seems to be a biologically acceptable approach as an auxiliary therapy in the treatment of septic process caused by pathogens dependent on iron supply (many bacterial and fungal pathogens), but the problem that is being raised certainly requires further experimental and clinical research.

CORRECTING OF ANEMIA USING IRON SUCROSE IN PATIENTS WITH CHRONIC KIDNEYDISEASE STAGE VD ON HEMODIALYSIS

Anemia is a common complication of CKD. Iron deficiency is one of a leading cause of anemia in HD patients. The causes of iron deficiency in these patients are multifactorial. Main factors that contribute to iron deficiency in HD patients are reduction intake and impaired intestinal absorption of dietary iron, blood losses, chronic inflammation and increased iron requirements during therapy with erythropoiesis–stimulating agents. Aim.The aim was to study efficacy and safety of iron sucrose (Venofer) in HD patients with anemia. Materials and methods. This study was an retrospective, epidemiologic, performed from 2010 to 2014 years. The study included 69 HD patients with anemia from dialysis single–center. 38 (55.1%) patients were men, average age 49,53 ± 3,9years and the most common cause of ESRD was glomerulonephritis (37 patients, 53.6%). Hemoglobin value was analyzed weekly. The levels of serum ferritin and transferrin saturation, were determined before and after treatment with Venofer. Results. Treatment with the Venofer resulted a significant increase of hematological and iron exchange parameters. At 2 – 3 weeks of therapy, hemoglobin levels increased by 7,6% and 10,7%, respectively. 14 days after the last dose Venoer serum ferritin and transferrin saturation levels have increased by 58% and 55%, respectively. Conclusions. Intravenous iron is the preferred route of administration in HD patients. Venofer showing a significant increase both of hemoglobin and iron exchange markers levels on a background of insignificant frequency of treatment–related adverse events.