nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1519Research ArticleШКОЛА НЕФРОЛОГАEDUCATIONAL MATERIALSЭффективность и переносимость терапии парентеральными препаратами железа у гемодиализных пациентов, сравнение препаратовTolerability and efficacy of parenteral iron therapy in hemodialysis patients, a comparison of preparationsХалидА. МониемKhalidA. Moniemnoemail@neicon.ruСунилБхандариSunilBhandarinoemail@neicon.ruDepartament of Renal Medicine, Hull and East Yorkshire Hospitals NHS Trust, Hull Royal Infirmary, Kingston upon Hull, UKРоссияDepartament of Renal Medicine, Hull and East Yorkshire Hospitals NHS Trust, Hull Royal Infirmary, Kingston upon Hull, UKRussian Federation20072306202594446451Copyright © Халид А.М., Сунил Б., 20252025Халид А.М., Сунил Б.Khalid A.M., Sunil B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/1519

Получено: 2 ноября 2006; внесены дополнения: 1 февраля 2007; принято к печати: 3 февраля 2007.®2007 The Authors Journal Compilation®2007 LMS Group · Transfusion Alternatives in Transfusion Medicine 9, 37-42 Перевод печатается с разрешения обладателя авторских прав. Пациенты на гемодиализе нуждаются в применении парентеральных препаратов железа для восполнения/поддержания достаточных запасов железа и оптимизации применения эритропоэтина (ЭПО). В Великобритании доступны два препарата железа для парентерального применения: декстран железа (Космофер) и сахарат железа (Венофер). Безопасность применения данных препаратов до сих пор остается предметом дискуссии. Для изучения безопасности и переносимости Космофера и Венофера было проведено обсервационное исследование пациентов с хронической почечной недостаточностью, и проспективное перекрестное исследование гемодиализных пациентов, исследовались побочные реакции, концентрация гемоглобина, ферритина, и дозы эритропоэтина. 144 пациента получали Космофер (2294 дозы), 110 получали Венофер (2111 доз). Всего в обеих группах отмечено 15 случаев побочных реакций, эпизодов анафилаксии не было. 39 пациентов (28 мужчин), средний возраст 60,5 лет, получавших Венофер, были переведены на введение Космофера на период 6 месяцев. Затем эти пациенты вновь были переведены на Венофер. За время исследования не было отмечено различий в концентрации гемоглобина, уровне ферритина и дозах эритропоэтина. На фоне введения 546 доз Космофера и 507 доз Венофера отмечено всего 13 случаев побочных реакций у 8 пациентов (8 при применении Космофера, 5 при применении Венофера). Перевод пациентов с введения Венофера на введение Космофера позволил уменьшить стоимость лечения на 77 фунтов на каждого больного за 6-месячный период исследования. В данном исследовании оба препарата для парентерального применения оказались одинаково безопасными и эффективными. Для подтверждения результатов исследования и возможного пересмотра европейских рекомендаций надлежащей клинической практики необходимо исследование больших когорт пациентов.

Hemodialysis patients require parenteral iron to replenish/maintain sufficient iron stores and optimize erythropoietin (EPO) use. Two parenteral iron preparations are available in the UK, iron dextran (CosmoFer) and iron sucrose (Venofer). Debate about their safety profiles continues. We performed an observational study of chronic kidney disease patients and a prospective crossover study in hemodialysis patients to examine the comparative safety and tolerability of CosmoFer and Venofer. Side effects, hemoglobin, ferritin and EPO dose were recorded. One hundred and forty-four patients received CosmoFer (2294 doses) and 110 received Venofer (2111 doses). Fifteen reactions occurred with no anaphylactic episodes in either group. Thirty-nine patients (28 men), mean age 60.5 years, on intravenous Venofer were converted to CosmoFer for 6 months. They were then converted back to Venofer. No differences in hemoglobin, EPO dose or ferritin levels throughout the study were observed. Side effects were minor after 546 and 507 doses of CosmoFer and Venofer (13 reactions (eight CosmoFer, five Venofer) occurred in eight patients). Conversion from Venofer to CosmoFer led to a cost saving of £77 per patient over the 6-month study period. In this study, the two forms of therapy were equally safe and effective. Examination of a larger cohort of patients is necessary to verify these findings and potentially reassess European Best Practice Guidelines.

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The authors declare that there are no conflicts of interest present.