Conclusions: Pseudomonas peritonitis is associated with high rates of catheter removal and permanent hemodialysis transfer. Prompt catheter removal and use of two anti-pseudomonal antibiotics are associated with better outcomes.
Treatment of chronic kidney disease (CKD) includes parenteral iron therapy, and these infusions can lead to iron overload. Secondary iron overload is typically treated with iron chelators, of which deferasirox is one of the most promising. However, it has not been studied in patients with CKD and iron overload. A pilot study was conducted to evaluate the pharmacokinetics and safety of deferasirox in 8 haemodialysis-dependent patients, who were receiving intravenous iron for treatment of anaemia of CKD. Deferasirox was administered at two doses (10 mg/kg and 15 mg/kg), either acute (once daily for two days) or steady-state (once daily for two weeks). A dose of 10 mg/kg in either protocol was not sufficient to achieve a plasma concentration in the therapeutic range (acute peak 14.1 and steady-state 22.8 µmol/l), while 15 mg/kg in either protocol maintained plasma concentration well above this range (acute peak 216 and steady-state 171 µmol/l). Plasma concentration observed at 15 mg/kg was well above that expected for this dose (40-50 µmol/l), although no adverse clinical events were observed. This study highlights the need to profile drugs such as deferasirox in specific patient groups, such as those with CKD and iron overload.3
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