Iron-deficiency anemia in chronic kidney disease

Iron Salt

Onset of action: Hematologic response to either oral or parenteral iron salts is essentially the same; red blood cell form and color changes within 3 to 10 days
Maximum effect: Peak reticulocytosis occurs in 5 to 10 days, and hemoglobin values increase within 2 to 4 weeks
Distribution: Vdss: Healthy adults: 7.9 L
Metabolism: Dissociated into iron and sucrose by the reticuloendothelial system
Half-life elimination: Healthy adults: 6 hours; Nondialysis-dependent adolescents: 8 hours
Excretion: Healthy adults: Urine (5%) within 24 hours

Known hypersensitivity to iron sucrose or any component of the formulation

B (FDA)

WHO: Compatible with breastfeeding

>10%:
Cardiovascular: Hypotension (2% to 3%; children: 2%; hemodialysis patients: 39%; may be related to total dose or rate of administration)
Central nervous system: Headache (3% to 13%; children: 6%)
Gastrointestinal: Nausea (5% to 15%; children: 3%)
Neuromuscular & skeletal: Muscle cramps (1% to 3%; hemodialysis patients: 29%)
Respiratory: Nasopharyngitis (2% to 16%), pharyngitis (2% to 16%), sinusitis (2% to 16%), upper respiratory tract infection (2% to 16%; children: 4%)

1. Children and Adolescents:
Slow IV injection: Administer undiluted over 5 minutes
Infusion: Infuse diluted solution over 5 to 60 minutes
2. Adults:
Slow IV injection: May administer doses ?200 mg undiluted by slow IV injection over 2 to 5 minutes. When administering to hemodialysis-dependent patients, give iron sucrose early during the dialysis session (generally within the first hour).
Infusion: Infuse diluted doses ?200 mg over at least 15 minutes; infuse diluted 300 mg dose over 1.5 hours; infuse diluted 400 mg dose over 2.5 hours; infuse diluted 500 mg dose over 3.5 to 4 hours (limited experience). When administering to hemodialysis-dependent patients, give iron sucrose early during the dialysis session.