Efficacy of administration of oral liposomal iron after a period of intravenous iron carboxymaltose in two groups of chronic kidney disease patients: home hemodialysis and conservative therapy

Author(s): Ennio Duranti*, Diletta Duranti, Filomena Panza and Chiara Ralli

Introduction: Anemia could be a frequent and early complication of Chronic nephropathy (CKD), and its prevalence will increase with the worsening of nephritic perform, involving over five hundredth of patients in predialysis (stage 5) and much nearly one hundred of patients in dialysis [1]. The administration of oral or blood vessel iron and glycoprotein (Epo) could be a key part for the correction of anemia each in patients with CKD and in patients on chronic dialysis. The aim of our work was to verify the effectiveness of oral liposomal iron in a very cluster of our home dialysis patients and in a very cluster of patients in conservative medical aid with CKD, examination it with a previous amount in blood vessel medical aid with carboxymaltose iron. Materials and methods: We screened 8 patients (5 F/3 M; age 62 ± 10 yrs) in chronic daily home hemodialysis for more than 12 months and 16 patients (9 F/7 M; age 75 ± 12 yrs) in conservative therapy, affected by CKD stage 3b-4, who were on treatment for a sideropenic anemia. All had been treated for at least 6 months, with carboxymaltose iron iv (500 mg/ month) and therefore the last hematological control was considered time 0. From that moment on, they were then passed to oral liposomal iron. The protocol lasted 6 months for home hemodialysis pts and 12 months for CKD pts. During these two periods, serum iron, serum Hb, Ferritin, Transferrin Saturation, CRP, Albumin, weekly consumption of erythropoietin were evaluated bimonthly. Statistical analysis was performed with Student's t test for paired data (Table 1). Results: Switching to the os iron periods, both in the group in dialysis that in conservative, compared to the end of the iv iron period, there was an improvement, even if not statistically significant, of the concentration of Hb and a reduction of CRP values. Ferritin, transferrin saturation, Albumin and weekly consumption of Erythropoietin did not change in the two pts groups.7 out of 16 CKD patients, throughout the period, did not use erythropoietin. No patient reported any side effects during intravenous or liposomal iron treatment and none has discontinued therapy.

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