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Ferric carboxymaltose versus ferric gluconate in hemodialysis patients: Reduction of erythropoietin dose in 4 years of follow-up

Kidney Research and Clinical Practice 2020년 39권 3호 p.334 ~ 343
Lacquaniti Antonio, Pasqualetti Patrizio, di Tocco Teresa Casuscelli, Campo Susanna, Rovito Stefania, Bucca Maurizio, Ragusa Antonino, Monardo Paolo,
소속 상세정보
 ( Lacquaniti Antonio ) - Papardo Hospital Nephrology and Dialysis Unit
 ( Pasqualetti Patrizio ) - Fatebenefratelli Foundation for Health Research and Education Service of Medical Statistics and IT
 ( di Tocco Teresa Casuscelli ) - Papardo Hospital Nephrology and Dialysis Unit
 ( Campo Susanna ) - Papardo Hospital Nephrology and Dialysis Unit
 ( Rovito Stefania ) - Papardo Hospital Nephrology and Dialysis Unit
 ( Bucca Maurizio ) - Papardo Hospital Nephrology and Dialysis Unit
 ( Ragusa Antonino ) - Papardo Hospital Nephrology and Dialysis Unit
 ( Monardo Paolo ) - Papardo Hospital Nephrology and Dialysis Unit

Abstract


Background: Ferric carboxymaltose (FCM) is a parenteral, dextran-free iron formulation designed to overcome the limitations of existing iron preparations. The main aim of this study was to retrospectively examine results obtained from a long period of FCM therapy in hemodialysis patients who have been previously treated with ferric gluconate (FX). Markers of iron metabolism, erythropoietin (EPO) doses, and effects on anemic status have been analysed.

Methods: The study was performed with a follow up period of 4 years, when patients were treated before with FX and then switched to FCM. A total of 25 patients were included in the study.

Results: FCM increased transferrin saturation (TSAT) levels by 11.9% (P < 0.001) with respect to FX. Events of TSAT less than 20% were reduced during FCM. The monthly dose of EPO was reduced in the FCM period (-6,404.1 international unit [IU]; 95% confidence interval, -10,643.5 IU; -2,164.6 IU; P = 0.003), as well as the erythropoietin resistance index (P = 0.004). During the period with FCM, ferritin levels were higher than during FX (P < 0.001), while transferrin was reduced (P = 0.001).

Conclusion: During FCM treatment, minor doses of EPO were administered if compared to those delivered during FX therapy. Stable and on target levels of hemoglobin were maintained with better control of anemia through high levels of ferritin and TSAT.

키워드

Anemia; Erythropoietin resistance index; Ferric carboxymaltose; Hemodialysis

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