A study of intravenous iron exposure in ESRD patients on haemodialysis

Introduction Intravenous iron in combination with erythropoietin therapy is essential in maintaining optimal haemoglobin level. However, data is limited on whether over exposure of iron is associated with increased morbidity and mortality in ESRD patients on haemodialysis (HD), especially infection...

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Main Authors:	Hamzah, Mohd Hazlan, Mohamad Nor, Fariz Safhan, Mat Nor, Khadijah, Seman, Mohd Ramli, MK, Ahmad, Draman, Che Rosle, Wan Ali, Wan Ahmad Syahril Rozli
Format:	Article
Language:	English
Published:	John Wiley & Sons, Inc. 2015
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/58969/ http://irep.iium.edu.my/58969/ http://irep.iium.edu.my/58969/18/iv%20iron%20ishd.pdf

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spelling	iium-589692017-11-23T04:10:33Z http://irep.iium.edu.my/58969/ A study of intravenous iron exposure in ESRD patients on haemodialysis Hamzah, Mohd Hazlan Mohamad Nor, Fariz Safhan Mat Nor, Khadijah Seman, Mohd Ramli MK, Ahmad Draman, Che Rosle Wan Ali, Wan Ahmad Syahril Rozli R Medicine (General) Introduction Intravenous iron in combination with erythropoietin therapy is essential in maintaining optimal haemoglobin level. However, data is limited on whether over exposure of iron is associated with increased morbidity and mortality in ESRD patients on haemodialysis (HD), especially infection related. Objectives To evaluate any association between cumulative iron dose and episodes of infections, all cause hospitalizations and mortality in patients on HD. Method All newly diagnosed ESRD patients initiated on HD in Pahang State of Malaysia government dialysis centers between 1 January 2014 and 31 December 2014 were included. Baseline demographics, cumulative iron dose (IV Cosmofer) over 3 months, haemoglobin level, ferritin level and transferrin saturation ratios (TSAT) were recorded. Patients’ outcome of infections, all causes hospitalisations and mortality were analysed. Results There were 123 patients included during which there were 17.9% infections, 43.9% all cause hospitalizations and 4.1% mortality. The mean 3-month cumulative iron dose was 473 + 17 mg and the maximum level was 3300 mg. The haemoglobin level is lower in patients with infections (8.3 + 1.0 g/dl vs 9.8 + 1.7 g/dl, p < 0.05), and in all causes hospitalisations (9.1 g/dl + 1.6 vs 9.8 g/dl + 1.7, p = 0.017). Mortality was associated with lower haemoglobin (7.8 + 1.5 g/dl vs 9.6 + 1.6 g/dl, p = 0.022). There was no significant relation between cumulative iron dose, level of ferritin or TSAT with infection, all causes hospitalisations or mortality. Conclusion Maintaining optimal haemoglobin level is essential to improve patients’ outcome. Increased cumulative iron dose was not related with higher infections, hospitalisations or mortality in our incident HD patients. Further larger prospective studies are needed to further clarify adverse effect, if any, of increased cumulative iron dose. John Wiley & Sons, Inc. 2015-09-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/58969/18/iv%20iron%20ishd.pdf Hamzah, Mohd Hazlan and Mohamad Nor, Fariz Safhan and Mat Nor, Khadijah and Seman, Mohd Ramli and MK, Ahmad and Draman, Che Rosle and Wan Ali, Wan Ahmad Syahril Rozli (2015) A study of intravenous iron exposure in ESRD patients on haemodialysis. Hemodialysis International, 19 (Supplement 2). S52. ISSN 1492-7535 E-ISSN 1542-4758 http://onlinelibrary.wiley.com/doi/10.1111/hdi.12368/full
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Hamzah, Mohd Hazlan Mohamad Nor, Fariz Safhan Mat Nor, Khadijah Seman, Mohd Ramli MK, Ahmad Draman, Che Rosle Wan Ali, Wan Ahmad Syahril Rozli A study of intravenous iron exposure in ESRD patients on haemodialysis
description	Introduction Intravenous iron in combination with erythropoietin therapy is essential in maintaining optimal haemoglobin level. However, data is limited on whether over exposure of iron is associated with increased morbidity and mortality in ESRD patients on haemodialysis (HD), especially infection related. Objectives To evaluate any association between cumulative iron dose and episodes of infections, all cause hospitalizations and mortality in patients on HD. Method All newly diagnosed ESRD patients initiated on HD in Pahang State of Malaysia government dialysis centers between 1 January 2014 and 31 December 2014 were included. Baseline demographics, cumulative iron dose (IV Cosmofer) over 3 months, haemoglobin level, ferritin level and transferrin saturation ratios (TSAT) were recorded. Patients’ outcome of infections, all causes hospitalisations and mortality were analysed. Results There were 123 patients included during which there were 17.9% infections, 43.9% all cause hospitalizations and 4.1% mortality. The mean 3-month cumulative iron dose was 473 + 17 mg and the maximum level was 3300 mg. The haemoglobin level is lower in patients with infections (8.3 + 1.0 g/dl vs 9.8 + 1.7 g/dl, p < 0.05), and in all causes hospitalisations (9.1 g/dl + 1.6 vs 9.8 g/dl + 1.7, p = 0.017). Mortality was associated with lower haemoglobin (7.8 + 1.5 g/dl vs 9.6 + 1.6 g/dl, p = 0.022). There was no significant relation between cumulative iron dose, level of ferritin or TSAT with infection, all causes hospitalisations or mortality. Conclusion Maintaining optimal haemoglobin level is essential to improve patients’ outcome. Increased cumulative iron dose was not related with higher infections, hospitalisations or mortality in our incident HD patients. Further larger prospective studies are needed to further clarify adverse effect, if any, of increased cumulative iron dose.
format	Article
author	Hamzah, Mohd Hazlan Mohamad Nor, Fariz Safhan Mat Nor, Khadijah Seman, Mohd Ramli MK, Ahmad Draman, Che Rosle Wan Ali, Wan Ahmad Syahril Rozli
author_facet	Hamzah, Mohd Hazlan Mohamad Nor, Fariz Safhan Mat Nor, Khadijah Seman, Mohd Ramli MK, Ahmad Draman, Che Rosle Wan Ali, Wan Ahmad Syahril Rozli
author_sort	Hamzah, Mohd Hazlan
title	A study of intravenous iron exposure in ESRD patients on haemodialysis
title_short	A study of intravenous iron exposure in ESRD patients on haemodialysis
title_full	A study of intravenous iron exposure in ESRD patients on haemodialysis
title_fullStr	A study of intravenous iron exposure in ESRD patients on haemodialysis
title_full_unstemmed	A study of intravenous iron exposure in ESRD patients on haemodialysis
title_sort	study of intravenous iron exposure in esrd patients on haemodialysis
publisher	John Wiley & Sons, Inc.
publishDate	2015
url	http://irep.iium.edu.my/58969/ http://irep.iium.edu.my/58969/ http://irep.iium.edu.my/58969/18/iv%20iron%20ishd.pdf
first_indexed	2023-09-18T21:23:27Z
last_indexed	2023-09-18T21:23:27Z
_version_	1777412034960293888

A study of intravenous iron exposure in ESRD patients on haemodialysis

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