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Intravenous (IV) iron infusion is a therapy in which a combination of iron and saline solution is delivered directly into the bloodstream through a vein, in patients suffering iron deficiency, iron-deficiency anaemia and chronic kidney disease.
Iron released from the heme generates reactive oxygen species, damaging the kidney cells. In addition to the myoglobinuria, two other mechanisms contribute to kidney impairment: low blood pressure leads to constriction of the blood vessels and therefore a relative lack of blood flow to the kidney, and finally uric acid may form crystals in the ...
The iron is then either stored for later use in the body or taken up by plasma. The plasma transfers the iron to hemoglobin, where it can begin increasing erythropoiesis (red blood cell production). [3] Iron sucrose is most commonly used to treat iron deficiency anemia, which can be caused by chronic kidney disease. [3]
The scarring of the small blood vessels, called capillary sclerosis, is the initial lesion of analgesic nephropathy. [7] Found in the renal pelvis, ureter, and capillaries supplying the nephrons, capillary sclerosis is thought to lead to renal papillary necrosis and, in turn, chronic interstitial nephritis.
Therefore, with frequent blood transfusions, iron builds up in the body over time. [2] This can enter the liver, heart, pancreas, and endocrine organs. [2] Free iron increases the production of oxygen radicals (mostly hydroxyl radicals) that cause damage to cells (particularly their DNA). [2]
Patients diagnosed with TACO should have at least 1 of the following two characteristics within 12 hours after the transfusion was ended: Acute or worsening respiratory distress (tachypnea, dyspnea, cyanosis, and/or hypoxemia) in the absence of other causes; Evidence of acute or worsening pulmonary edema (by physical examination or chest imaging)
Pain; Pruritis (itching) [4] Swelling [5] Induration (hardening of the skin) [6] Discoloration [6] Severe reactions may result in cutaneous necrosis at the injection site, typically presenting in one of two forms: (1) those associated with intravenous infusion or (2) those related to intramuscular injection.
Iron sucrose is used for patients with iron-deficiency anemia, including those with chronic kidney disease, when oral iron therapy is ineffective or impractical. Iron sucrose is given by slow intravenous injection or intravenous infusion. For haemodialysis patients, it may be given into the venous limb of the dialyser. [28]