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    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;Dear Editor&#44; </span>&#160;</p><p class="elsevierStylePara">&#160;The 2006 K&#47;DOQI guidelines on anaemia in patients on chronic haemodialysis &#40;HD&#41; indicate that treatment should be done with IV Fe in order to maintain a ferritin &#40;FER&#41; value of more than 200- 500&#956;g&#47;l to achieve adequate erythropoiesis&#46;<span class="elsevierStyleSup">1 </span>Other studies<span class="elsevierStyleSup">2&#44;3 </span>state that FER should be kept in a higher range&#44; but there are no controlled studies comparing the efficacy as measured by the Hb&#44; EPO dose&#44; and iatrogenic sequelae<span class="elsevierStyleSup">4&#44;5 </span>in groups of patients with FER values above and below 500&#44; with maximum values greater than 500 indicating high doses of IV Fe&#46; Recent research shows that administration of low dose IV Fe on a continual basis causes increased protein oxidation&#44; something that does not happen often with intermittent treatment&#46;<span class="elsevierStyleSup">6 </span>&#160;</p><p class="elsevierStylePara">&#160;The purpose of this prospective observational case-control study is to evaluate&#44; in 10 patients on HD&#44; if the Hb and EPO dose changed with IV Fe administration in two different treatment protocols&#44; lasting six months each&#46; Patients were included after ruling out factors affecting erythropoiesis for six months before and during the study &#40;transfusion&#44; infection&#44; inflammation&#44; malnutrition&#44; surgery&#44; hospitalisation&#44; severe hyperparathyroidism&#44; etc&#46;&#41;&#46; <span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;FER1 Protocol&#46; </span>Treated with 50mg Fe sucrose IV&#47;1 HD session&#44; 8 HD in a row &#40;400mg&#41; to achieve and maintain a maximum FER value greater than and close to 300&#956;g&#47;l&#59; data collection six months before the start of the FER2 protocol&#46; <span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;FER2 Protocol&#46; </span>Treated with 25 mg Fe sucrose IV&#47;1 weekly HD session for 16 weeks in a row &#40;400mg&#41; to achieve and maintain a maximum FER value greater than and close to 300&#956;g&#47;l&#59; data collection from the fourth month of starting&#46; FER was assessed&#44; then 2 months to assess continued treatment in the two protocols&#44; and we did not treat with IV Fe if there was an acute infection&#46; &#160;</p><p class="elsevierStylePara">&#160;In each protocol we assessed&#58; intact PTH&#47;3 months&#44; balanced KTV &#40;Daugirdas&#41;&#47;month&#44; albumin g&#47;l&#47;3 months&#44; subjective global assessment of nutrition&#44; PCR&#47;3 months&#44; Hb&#47;month&#44; EPO dose in units&#47;kg&#47;week&#44; ferritin&#47;2 months&#44; total dose of IV Fe in mg&#47;patient&#47;6 months &#40;Fe 6&#41;&#44; total dose of IV Fe in mg&#47;patient&#47;1 month &#40;Fe 1&#41;&#44; range in mg&#47;patient of Fe 6 &#40;range Fe 6&#41;&#46; Age &#40;75 &#177; 12 years&#41;&#44; female sex &#40;40&#37;&#41;&#44; HD time in months and with vascular access&#44; and high-flow membranes were similar&#46; There was no statistically significant difference in PTH &#40;268 &#177; 249&#44; FER1 vs&#46; 297 &#177; 198&#44; FER2&#41;&#44; eKTV &#40;1&#46;37 &#177; 0&#46;1&#44; FER1 vs&#46; 1&#46;34 &#177; 0&#46;1&#44; FER2&#41;&#44; albumin &#40;36&#46;3 &#177; 3&#44; FER1 versus 35&#46;4 &#177; 3&#44; FER2&#41;&#44; mild malnutrition in both groups&#44; CRP &#40;11&#46;4 &#177; 9&#44; FER1 vs&#46; 13 &#177; 11&#44; FER2&#41;&#44; or in the main variables&#58; Hb &#40;12&#46;4 &#177; 0&#46;4&#44; FER1 versus 12&#46;3 &#177; 0&#46;3&#44; FER2&#41;&#44; EPO &#40;99 &#177; 51&#44; FER1 vs&#46; 85 &#177; 46&#44; FER2&#41;&#44; Fe 6 &#40;854 &#177; 204mg&#44; FER1 vs&#46; 598 &#177; 126&#44; FER2&#41;&#44; Fe 1 &#40;142 &#177; 34mg&#44; FER1 vs&#46; 99 &#177; 21&#44; FER2&#41; and Fe 6 range &#40;500- 1100mg&#44; FER1 vs&#46; 400 to 800mg&#44; FER2&#41;&#44; but there was a difference with p &#60; 0&#46;05 in FER &#40;332 &#177; 24&#44; FER1 vs&#46; 225 &#177; 37&#44; FER2&#41;&#46; &#160;</p><p class="elsevierStylePara">&#160;This prospective observational casecontrol study of patients on HD shows that Hb&#44; EPO dose&#44; and dose of IV Fe administered with the two protocols &#40;FER maximum range greater than and close to 300&#956;g&#47;l vs FER maximum value of less than and close to 300&#41; do not change&#46; Prior scientific evidence<span class="elsevierStyleSup">1&#44;4 </span>and data from this research suggest achieving adequate erythropoiesis when treating with IV Fe&#44; reducing iatrogenic sequelae&#44;<span class="elsevierStyleSup">4&#44;5 </span>and keeping the maximum FER greater than or less than and close to 300&#956;g&#47;l&#46; Based on current evidence&#44;<span class="elsevierStyleSup">6 </span>it would be advisable to treat intermittently with low dose Fe&#46; <span class="elsevierStyleBold">&#160;</span></p>"
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Treatment with intravenous iron and ferritin level
TRATAMIENTO CON HIERRO INTRAVENOSO Y NIVEL DE FERRITINA
Juan Fernández-Gallegoa, María Adoración Martína, Seema Sujana, Encarnacion Vegaa
a Servicio de Nefrología, Hospital Carlos Haya, Málaga, Málaga, España,
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something that does not happen often with intermittent treatment&#46;<span class="elsevierStyleSup">6 </span>&#160;</p><p class="elsevierStylePara">&#160;The purpose of this prospective observational case-control study is to evaluate&#44; in 10 patients on HD&#44; if the Hb and EPO dose changed with IV Fe administration in two different treatment protocols&#44; lasting six months each&#46; Patients were included after ruling out factors affecting erythropoiesis for six months before and during the study &#40;transfusion&#44; infection&#44; inflammation&#44; malnutrition&#44; surgery&#44; hospitalisation&#44; severe hyperparathyroidism&#44; etc&#46;&#41;&#46; <span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;FER1 Protocol&#46; </span>Treated with 50mg Fe sucrose IV&#47;1 HD session&#44; 8 HD in a row &#40;400mg&#41; to achieve and maintain a maximum FER value greater than and close to 300&#956;g&#47;l&#59; data collection six months before the start of the FER2 protocol&#46; <span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;FER2 Protocol&#46; </span>Treated with 25 mg Fe sucrose IV&#47;1 weekly HD session for 16 weeks in a row &#40;400mg&#41; to achieve and maintain a maximum FER value greater than and close to 300&#956;g&#47;l&#59; data collection from the fourth month of starting&#46; FER was assessed&#44; then 2 months to assess continued treatment in the two protocols&#44; and we did not treat with IV Fe if there was an acute infection&#46; &#160;</p><p class="elsevierStylePara">&#160;In each protocol we assessed&#58; intact PTH&#47;3 months&#44; balanced KTV &#40;Daugirdas&#41;&#47;month&#44; albumin g&#47;l&#47;3 months&#44; subjective global assessment of nutrition&#44; PCR&#47;3 months&#44; Hb&#47;month&#44; EPO dose in units&#47;kg&#47;week&#44; ferritin&#47;2 months&#44; total dose of IV Fe in mg&#47;patient&#47;6 months &#40;Fe 6&#41;&#44; total dose of IV Fe in mg&#47;patient&#47;1 month &#40;Fe 1&#41;&#44; range in mg&#47;patient of Fe 6 &#40;range Fe 6&#41;&#46; Age &#40;75 &#177; 12 years&#41;&#44; female sex &#40;40&#37;&#41;&#44; HD time in months and with vascular access&#44; and high-flow membranes were similar&#46; There was no statistically significant difference in PTH &#40;268 &#177; 249&#44; FER1 vs&#46; 297 &#177; 198&#44; FER2&#41;&#44; eKTV &#40;1&#46;37 &#177; 0&#46;1&#44; FER1 vs&#46; 1&#46;34 &#177; 0&#46;1&#44; FER2&#41;&#44; albumin &#40;36&#46;3 &#177; 3&#44; FER1 versus 35&#46;4 &#177; 3&#44; FER2&#41;&#44; mild malnutrition in both groups&#44; CRP &#40;11&#46;4 &#177; 9&#44; FER1 vs&#46; 13 &#177; 11&#44; FER2&#41;&#44; or in the main variables&#58; Hb &#40;12&#46;4 &#177; 0&#46;4&#44; FER1 versus 12&#46;3 &#177; 0&#46;3&#44; FER2&#41;&#44; EPO &#40;99 &#177; 51&#44; FER1 vs&#46; 85 &#177; 46&#44; FER2&#41;&#44; Fe 6 &#40;854 &#177; 204mg&#44; FER1 vs&#46; 598 &#177; 126&#44; FER2&#41;&#44; Fe 1 &#40;142 &#177; 34mg&#44; FER1 vs&#46; 99 &#177; 21&#44; FER2&#41; and Fe 6 range &#40;500- 1100mg&#44; FER1 vs&#46; 400 to 800mg&#44; FER2&#41;&#44; but there was a difference with p &#60; 0&#46;05 in FER &#40;332 &#177; 24&#44; FER1 vs&#46; 225 &#177; 37&#44; FER2&#41;&#46; &#160;</p><p class="elsevierStylePara">&#160;This prospective observational casecontrol study of patients on HD shows that Hb&#44; EPO dose&#44; and dose of IV Fe administered with the two protocols &#40;FER maximum range greater than and close to 300&#956;g&#47;l vs FER maximum value of less than and close to 300&#41; do not change&#46; Prior scientific evidence<span class="elsevierStyleSup">1&#44;4 </span>and data from this research suggest achieving adequate erythropoiesis when treating with IV Fe&#44; reducing iatrogenic sequelae&#44;<span class="elsevierStyleSup">4&#44;5 </span>and keeping the maximum FER greater than or less than and close to 300&#956;g&#47;l&#46; Based on current evidence&#44;<span class="elsevierStyleSup">6 </span>it would be advisable to treat intermittently with low dose Fe&#46; <span class="elsevierStyleBold">&#160;</span></p>"
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Article information
ISSN: 20132514
Original language: English
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2024 September 82 23 105
2024 August 92 52 144
2024 July 56 30 86
2024 June 84 43 127
2024 May 59 44 103
2024 April 60 51 111
2024 March 45 30 75
2024 February 45 27 72
2024 January 37 24 61
2023 December 42 26 68
2023 November 61 28 89
2023 October 89 32 121
2023 September 71 39 110
2023 August 45 14 59
2023 July 68 25 93
2023 June 41 20 61
2023 May 55 27 82
2023 April 54 23 77
2023 March 63 17 80
2023 February 43 18 61
2023 January 49 31 80
2022 December 59 37 96
2022 November 71 38 109
2022 October 66 76 142
2022 September 70 45 115
2022 August 96 43 139
2022 July 74 42 116
2022 June 81 37 118
2022 May 77 31 108
2022 April 78 50 128
2022 March 103 54 157
2022 February 112 57 169
2022 January 58 39 97
2021 December 55 40 95
2021 November 59 30 89
2021 October 84 43 127
2021 September 41 26 67
2021 August 73 33 106
2021 July 73 27 100
2021 June 47 24 71
2021 May 60 26 86
2021 April 172 49 221
2021 March 112 51 163
2021 February 122 19 141
2021 January 73 15 88
2020 December 86 13 99
2020 November 77 8 85
2020 October 65 15 80
2020 September 88 8 96
2020 August 73 5 78
2020 July 87 15 102
2020 June 91 10 101
2020 May 85 13 98
2020 April 63 21 84
2020 March 106 13 119
2020 February 93 15 108
2020 January 105 20 125
2019 December 100 18 118
2019 November 106 21 127
2019 October 49 9 58
2019 September 72 26 98
2019 August 57 20 77
2019 July 49 18 67
2019 June 57 22 79
2019 May 40 11 51
2019 April 96 28 124
2019 March 133 24 157
2019 February 86 21 107
2019 January 46 12 58
2018 December 82 33 115
2018 November 91 17 108
2018 October 84 8 92
2018 September 68 11 79
2018 August 56 11 67
2018 July 40 13 53
2018 June 34 8 42
2018 May 44 10 54
2018 April 44 13 57
2018 March 34 10 44
2018 February 42 6 48
2018 January 28 8 36
2017 December 50 7 57
2017 November 33 10 43
2017 October 28 6 34
2017 September 27 8 35
2017 August 28 6 34
2017 July 28 9 37
2017 June 20 8 28
2017 May 28 14 42
2017 April 21 10 31
2017 March 24 4 28
2017 February 22 17 39
2017 January 19 14 33
2016 December 53 8 61
2016 November 58 12 70
2016 October 88 11 99
2016 September 101 5 106
2016 August 166 4 170
2016 July 147 9 156
2016 June 131 0 131
2016 May 133 0 133
2016 April 91 0 91
2016 March 77 0 77
2016 February 88 0 88
2016 January 70 0 70
2015 December 101 0 101
2015 November 84 0 84
2015 October 75 0 75
2015 September 55 0 55
2015 August 65 0 65
2015 July 56 0 56
2015 June 30 0 30
2015 May 45 0 45
2015 April 8 0 8
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?