ferric-oxide--saccharated and Bacterial-Infections

Studies have reported conflicting findings on the infection risk posed by intravenous iron supplementation among hemodialysis (HD) patients. We used a novel study design to assess associations between intravenous iron and infectious diseases.. Patients initiating HD between 1998 and 2008 were extracted from Taiwan's National Health Insurance Research Database. Their first infectious disease in the period between 1.5 years after dialysis initiation and 2010 was identified and defined as the index date. Through the case-crossover design, the odds of exposure to intravenous iron within the 1-month period immediately preceding the index date (i.e., the case period) were compared with iron exposure in three different matched control periods for the same enrollee, thus possibly reducing some unmeasured confounders.. A total of 1410 patients who met our enrollment criteria were extracted from incident HD patients. The odds of intravenous iron exposure during the case period versus total control periods exhibited no significant difference (odds ratio: 1.000, 95% confidence interval: 0.75-1.33). In subgroup analyses, this association remained nonsignificant across patients with diabetes mellitus, heart failure, chronic lung disease, venous catheter for HD, and higher iron load.. We found that intravenous iron supplementation did not increase short-term infection risk among HD patients.

Topics: Administration, Intravenous; Adult; Aged; Bacterial Infections; Cohort Studies; Cross-Over Studies; Databases, Factual; Diabetes Mellitus; Epidemiologic Methods; Female; Ferric Compounds; Ferric Oxide, Saccharated; Heart Failure; Hematinics; Humans; Iron; Iron-Dextran Complex; Kidney Failure, Chronic; Lung Diseases; Male; Middle Aged; Multimorbidity; National Health Programs; Renal Dialysis; Taiwan; Time Factors; Young Adult

Some studies have suggested that intravenous iron therapy may be associated with an increased risk of infection. We analyzed the incidence of bacterial infection in 111 hemodialysis patients. Group 1 (n = 39, transferrin saturation <20%) received 10 doses of 100 mg of intravenous iron saccharate, 3 doses per week (28 treatment days); Group 2 (n = 13, transferrin saturation <20%) received 20 doses, 3 doses per week (70 treatment days); and Group 3 (n = 59, transferrin saturation 20-50%) received 10 doses, 1 dose per week (70 treatment days). The follow-up was 150 days for all groups, and all infectious episodes were recorded. Pulmonary infection was the most frequent event observed in all of the groups. In an incidence-density analysis, Group 2, which received a total of 20 doses, presented a significantly higher incidence of infection than Group 3, which received only 10 doses over the same period (0.13 versus 0.06 infections per patient per month, p = 0.04). No difference was observed between Groups 1 and 2 suggesting that the risk of infection during iron therapy is dose dependent rather than time length dependent.

Topics: Adult; Bacterial Infections; Female; Ferric Compounds; Ferric Oxide, Saccharated; Glucaric Acid; Humans; Male; Middle Aged; Renal Dialysis; Sucrose