Efficacy of Oral Versus Injectable Iron in Patients With Chronic Kidney Disease: A Two-Year Cross-Sectional Study Conducted at a Rural Teaching Hospital

Abstract

Anaemia (particularly iron deficiency) is of important concern in patients with chronic kidney disease (CKD) as it reflects the outcome of the disease. Current recommendations for the use of intravenous iron (IV) therapy in the management of anaemia in such patients are limited. This study highlights the comparison of oral to intravenous iron in patients with chronic kidney disease. Materials and methodsThis is a prospective case-control study comparing intravenous iron to oral iron in chronic kidney disease patients admitted to the Medicine Department of Acharya Vinoba Bhave Rural Hospital, in central India from October 2018 to October 2020. A total of 150 patients were divided into two groups of 75 each, one receiving oral iron (ferrous sulfate 325 mg tablets) and the other intravenous iron (IV iron sucrose). ResultsSerum iron, serum ferritin, and transferrin saturation (TS) showed increased levels in the IV iron group than in the oral iron group. In the IV group, a statistically significant increase was found in haemoglobin levels after therapy among all stages of kidney disease (p<0.05) while the same was not reported in the oral iron group. ConclusionIV iron sucrose therapy had been found to be effective, well-tolerated, and more successful than oral iron treatment in chronic kidney disease patients as far as the parameter of iron deficiency anaemia is concerned.

Intravenous versus oral iron supplementation in adult patients with iron-deficiency anemia and non-dialysis dependent chronic kidney disease: A meta-analysis of randomized clinical trials

“…The present review differed from the previous two reviews and their updates on focusing on NDD-CKD patients only, as less evidence seemed to advocate using IV iron with this subset of patients contrary to patients on dialysis. In addition, we excluded studies that were available only as abstracts and we included an RCT that was published in 2022 (Agrawal et al, 2022).…”

“…Patients on oral iron supplementation frequently suffer from gastrointestinal-related adverse effects such as nausea and/or vomiting, diarrhea and constipation (Lopez et al, 2016), which may negatively impact patients' adherence to treatment. Meanwhile, IV iron administration has been associated with more serious and potentially life-threatening adverse effects, including pulmonary embolism, anaphylactic reaction, hypotension and infection; though these adverse effects are relatively rare (Fishbane et al, 2014;Lopez et al, 2016;Roger et al, 2017;Agrawal et al, 2022). Consequently, IV iron should be administered under supervision, resulting in increased costs, hospital visits and inconvenience to patients.…”

“…The used doses and duration of treatment for the same preparation varied among the studies. The distribution of gender also varied, with four studies having a higher proportion of male participants than females(Stoves et al, 2001; Nagaraju et al, 2013;Agarwal et al, 2015;Agrawal et al, 2022).…”

Chronic Kidney Disease of Unknown Origin: Think Beyond Common Etiologies

“…There are a few treatment options now available for anemia in these individuals using intravenous iron (IV) therapy. In terms of the criterion of iron deficiency anemia, IV iron sucrose therapy has been proven to be more beneficial, acceptable, and efficacious in individuals with CKD than oral iron treatment [ 35 ].…”

Effectiveness of Dialysis in Psoriasis: A Short Review

“…The prevalence of psoriasis varies around the globe. Prevalence in various communities ranges from 0% to 11.8 %, according to published reports [36][37][38]. The range for the majority of the data is from roughly 0.5% to almost 2.5%.…”