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7. Controversies in optimal anemia management: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference

Author

Abu-Alfa, Ali K., Afsar, Baris, Pai, Amy Barton, Besarab, Anatole, Moore, Geraldine Biddle, Casadevall, Nicole, Cases, Aleix, de Francisco, Angel, Eckardt, Kai-Uwe, Fishbane, Steven, Fried, Linda F., Ganz, Tomas, Ginzburg, Yelena Z., Gómez, Rafael, Goodnough, Lawrence T., Hamano, Takayuki, Hanudel, Mark R., Hao, Chuan-Ming, Iseki, Kunitoshi, Ix, Joachim H., Johansen, Kirsten L., Ketteler, Markus, Kovesdy, Csaba P., Leaf, David E., Macdougall, Iain C., Massy, Ziad A., McMahon, Lawrence P., Minutolo, Roberto, Nakanishi, Takeshi, Nemeth, Elizabeta, Obrador, Gregorio T., Parfrey, Patrick S., Park, Hyeong-Cheon, Pecoits-Filho, Roberto, Robinson, Bruce M., Roger, Simon D., Shah, Yatrik M., Spinowitz, Bruce S., Tanaka, Tetsuhiro, Tsukamoto, Yusuke, Tungsanga, Kriang, Walther, Carl P., Yee-Moon Wang, Angela, Wolf, Myles, Babitt, Jodie L., Eisenga, Michele F., Haase, Volker H., Kshirsagar, Abhijit V., Levin, Adeera, Locatelli, Francesco, Małyszko, Jolanta, Swinkels, Dorine W., Tarng, Der-Cherng, Cheung, Michael, Jadoul, Michel, Winkelmayer, Wolfgang C., and Drüeke, Tilman B.

Published
2021
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9. Iron management in chronic kidney disease: conclusions from a “Kidney Disease: Improving Global Outcomes” (KDIGO) Controversies Conference

Author

Macdougall, Iain C, Bircher, Andreas J, Eckardt, Kai-Uwe, Obrador, Gregorio T, Pollock, Carol A, Stenvinkel, Peter, Swinkels, Dorine W, Wanner, Christoph, Weiss, Günter, Chertow, Glenn M, Participants, Conference, Adamson, John W, Akizawa, Tadao, Anker, Stefan D, Auerbach, Michael, Bárány, Peter, Besarab, Anatole, Bhandari, Sunil, Cabantchik, Ioav, Collins, Alan J, Coyne, Daniel W, de Francisco, Ángel LM, Fishbane, Steven, Gaillard, Carlo AJM, Ganz, Tomas, Goldsmith, David J, Hershko, Chaim, Jankowska, Ewa A, Johansen, Kirsten L, Kalantar-Zadeh, Kamyar, Kalra, Philip A, Kasiske, Bertram L, Locatelli, Francesco, Małyszko, Jolanta, Mayer, Gert, McMahon, Lawrence P, Mikhail, Ashraf, Nemeth, Elizabeta, Pai, Amy Barton, Parfrey, Patrick S, Pecoits-Filho, Roberto, Roger, Simon D, Rostoker, Guy, Rottembourg, Jacques, Singh, Ajay K, Slotki, Itzchak, Spinowitz, Bruce S, Tarng, Der-Cherng, Tentori, Francesca, Toblli, Jorge E, Tsukamoto, Yusuke, Vaziri, Nosratola D, Winkelmayer, Wolfgang C, Wheeler, David C, and Zakharova, Elena

Subjects
Hematology, Digestive Diseases, Nutrition, Kidney Disease, Patient Safety, Liver Disease, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Renal and urogenital, Good Health and Well Being, Cardiovascular Diseases, Ferritins, Hematinics, Hemoglobins, Hepcidins, Humans, Hypersensitivity, Infections, Iron, Iron Deficiencies, Iron Overload, Oxidative Stress, Renal Insufficiency, Chronic, chronic kidney disease, hypersensitivity, infections, iron, overload, oxidative stress, Conference Participants, Clinical Sciences, Urology & Nephrology
Abstract

Before the introduction of erythropoiesis-stimulating agents (ESAs) in 1989, repeated transfusions given to patients with end-stage renal disease caused iron overload, and the need for supplemental iron was rare. However, with the widespread introduction of ESAs, it was recognized that supplemental iron was necessary to optimize hemoglobin response and allow reduction of the ESA dose for economic reasons and recent concerns about ESA safety. Iron supplementation was also found to be more efficacious via intravenous compared to oral administration, and the use of intravenous iron has escalated in recent years. The safety of various iron compounds has been of theoretical concern due to their potential to induce iron overload, oxidative stress, hypersensitivity reactions, and a permissive environment for infectious processes. Therefore, an expert group was convened to assess the benefits and risks of parenteral iron, and to provide strategies for its optimal use while mitigating the risk for acute reactions and other adverse effects.

Published
2016

18. Effectiveness of low-dose iron treatment in non-anaemic iron-deficient women: a prospective open-label single-arm trial

Author

Simic, Stana, primary, Karczewski, Maximilian, additional, Klapdor, Silke, additional, Nowak, Albina, additional, Schubert, Morton, additional, Moretti, Diego, additional, Swinkels, Dorine W., additional, Beuschlein, Felix, additional, Saleh, Lanja, additional, Suter, Paolo, additional, and Krayenbuehl, Pierre-Alexandre, additional

Published
2023
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20. Effectiveness of low-dose iron treatment in non-anaemic iron-deficient women: a prospective open-label single-arm trial

Author

Simic, Stana, Karczewski, Maximilian, Klapdor, Silke, Nowak, Albina; https://orcid.org/0000-0002-4119-5516, Schubert, Morton, Moretti, Diego; https://orcid.org/0000-0002-7366-2182, Swinkels, Dorine W, Beuschlein, Felix; https://orcid.org/0000-0001-7826-3984, Saleh, Lanja; https://orcid.org/0000-0003-3364-7954, Suter, Paolo, Krayenbuehl, Pierre-Alexandre, Simic, Stana, Karczewski, Maximilian, Klapdor, Silke, Nowak, Albina; https://orcid.org/0000-0002-4119-5516, Schubert, Morton, Moretti, Diego; https://orcid.org/0000-0002-7366-2182, Swinkels, Dorine W, Beuschlein, Felix; https://orcid.org/0000-0001-7826-3984, Saleh, Lanja; https://orcid.org/0000-0003-3364-7954, Suter, Paolo, and Krayenbuehl, Pierre-Alexandre

Abstract

BACKGROUND: Iron deficiency without anaemia is highly prevalent and is particularly associated with fatigue, cognitive impairment, or poor physical endurance. Standard oral iron therapy often results in intestinal irritation with associated side effects and premature discontinuation of therapy, therefore, optimal oral iron therapy with sufficient iron absorption and minimal side effects is desirable. METHODS: Thirty-six iron-deficient non-anaemic premenopausal women (serum ferritin ≤30 ng/ml, haemoglobin ≥117 g/l) with normal body mass index (BMI) and no hypermenorrhea received 6 mg of elemental oral iron (corresponding to 18.6 mg ferrous sulphate) twice daily for 8 weeks. RESULTS: Participants treated with low-dose iron had an average age of 28 years and a BMI of 21 kg/m2. Their serum ferritin and haemoglobin increased significantly from 18 ng/ml to 33 ng/ml (p <0.001) and from 135 g/l to 138 g/l (p = 0.014), respectively. Systolic blood pressure increased from 114 mmHg to 120 mmHg (p = 0.003). Self-reported health status improved after 8 weeks (p <0.001) and only one woman reported gastrointestinal side effects (3%). CONCLUSION: This prospective open-label single-arm trial shows that oral iron treatment of 6 mg of elemental iron twice daily over 8 weeks is effective in iron-deficient non-anaemic women. Due to the negligible side effects, low-dose iron treatment is a valuable therapeutic option for iron-deficient non-anaemic women with normal BMI and menstruation. Further placebo-controlled studies with a larger number of participants are needed to confirm these results. ClinicalTrials.gov NCT04636060

Published
2023

43. Variant ASGR1 Associated with a Reduced Risk of Coronary Artery Disease

Author

Nioi, Paul, Sigurdsson, Asgeir, Thorleifsson, Gudmar, Helgason, Hannes, Agustsdottir, Arna B., Norddahl, Gudmundur L., Helgadottir, Anna, Magnusdottir, Audur, Jonasdottir, Aslaug, Gretarsdottir, Solveig, Jonsdottir, Ingileif, Steinthorsdottir, Valgerdur, Rafnar, Thorunn, Swinkels, Dorine W., Galesloot, Tessel E., Grarup, Niels, Jørgensen, Torben, Vestergaard, Henrik, Hansen, Torben, Lauritzen, Torsten, Linneberg, Allan, Friedrich, Nele, Krarup, Nikolaj T., Fenger, Mogens, Abildgaard, Ulrik, Hansen, Peter R., Galløe, Anders M., Braund, Peter S., Nelson, Christopher P., Hall, Alistair S., Williams, Michael J.A., van Rij, Andre M., Jones, Gregory T., Patel, Riyaz S., Levey, Allan I., Hayek, Salim, Shah, Svati H., Reilly, Muredach, Eyjolfsson, Gudmundur I., Sigurdardottir, Olof, Olafsson, Isleifur, Kiemeney, Lambertus A., Quyyumi, Arshed A., Rader, Daniel J., Kraus, William E., Samani, Nilesh J., Pedersen, Oluf, Thorgeirsson, Gudmundur, Masson, Gisli, Holm, Hilma, Gudbjartsson, Daniel, Sulem, Patrick, Thorsteinsdottir, Unnur, and Stefansson, Kari

Published
2016
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