Background: Iron deficiency anemia in the perioperative setting is treated predominantly with intravenous iron formulation, of which ferric carboxymaltose may induce hypophosphatemia by modulating fibroblast growth factor 23.
Methods: In this single-center, prospective, randomized, double-blind trial, we consented 92 adult patients scheduled for elective major abdominal or thoracic surgery. These patients either had isolated iron deficiency (plasma ferritin <100 ng/mL or transferrin saturation < 20 %) or iron deficiency anemia (hemoglobin (Hb) 100-130 g/L with plasma ferritin <100 ng/mL or transferrin saturation < 20 %). Preoperatively, participants received a single preoperative intravenous dose of ferric carboxymaltose and were then randomly assigned to receive either phosphate or placebo, administered orally three times a day for 30 days corresponding to an 18 mmol dose of daily phosphate supplementation in the intervention group. The primary endpoint was the minimum serum phosphate concentration during follow-up visits. The key secondary efficacy endpoint was mean perioperative hemoglobin concentration of postoperative days 0, 2 and 4, assessing the non-inferiority of additional phosphate supplementation.
Results: We randomly consented 46 patients in each group (mean ± SD age 56 ± 17 years, 57 % female). Minimal phosphate concentration was 0.49 ± 0.21 mmol/L in the treatment group and 0.42 ± 0.17 mmol/L in the placebo group (p = 0.12, two-sided p-value). Average mean hemoglobin was 110 ± 16 g/L in the treatment and 113 ± 13 g/L in the placebo group (p = 0.023, one-sided p-value for non-inferiority). Hypophosphatemia occurred in 32 patients (70 %) of the treatment group and in 39 patients (85 %) of the placebo group (odds ratio 0.15, 95 % CI from 0.02 to 0.77, p = 0.014). Secondary outcomes, such as rescue medication use, core muscle strength and MOCA test scores, did not differ between groups.
Conclusion: Co-administration of oral phosphate supplementation to ferric carboxymaltose cannot prevent hypophosphatemia. However, hypophosphatemia occurs in fewer patients. Phosphate co-administration did not impede the treatment of iron deficiency anemia with ferric carboxymaltose.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.jclinane.2024.111727 | DOI Listing |
Mol Biol Rep
December 2024
Postgraduate Program in Animal Bioscience, Federal University of Jataí, Jataí, Goiás, Brazil.
Trace elements (TEs) are essential for human health and for maintaining immune responses against potentially aggressive pathogens, such as the human immunodeficiency virus (HIV). During the infectious process, the body needs greater amounts of TEs in order to coordinate an efficient immune response to combat the invading agent, a condition that reflects in lymphocyte proliferation and activation of the antioxidant defense system of neutrophils and macrophages. Thus, during the progression phase of a viral infection, immunomodulation of TEs such as iron, zinc, chromium, magnesium, selenium, copper, calcium, and manganese occurs, can lead to immunosuppression and increased oxidative stress.
View Article and Find Full Text PDFEur J Nutr
December 2024
Humanify Centro de Bienestar Integral, Instituto de Investigación Nutricional - IIN, Lima, Peru.
Background And Purpose: Bioavailability studies and observational evidence suggest that heme iron (HI) may have greater impact on iron status indicators compared with non-heme iron (NHI). This systematic review and meta-analysis aimed to review the current evidence on the effect of the administration of HI compared with NHI for improving iron status in non-hospitalized population groups.
Methods: We searched Pubmed, CENTRAL, Scopus, Web of Science, and LILACS from inception to July 2024.
Cell Mol Biol (Noisy-le-grand)
November 2024
Department of Nutrition & Dietetics, National University of Medical Sciences, Rawalpindi, Pakistan.
Iron fortification compounds are of special interest to treat iron deficiency anemia, however, the dose-response effects of these fortificants on liver and renal functions have not been extensively reported in human subjects. The present study determines the effects of prebiotics and iron fortificants on liver function tests (LFTs) and renal function tests (RFTs) among women of reproductive age (WRA). A double-blind randomized controlled trial was performed for the duration of 90 days.
View Article and Find Full Text PDFJ Allergy Clin Immunol Pract
December 2024
Elliot and Roslyn Jaffe Food Allergy Institute, Division of Pediatric Allergy & Immunology, Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address:
Blood Cells Mol Dis
December 2024
Pediatrics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, United States of America. Electronic address:
Data support that fetal iron delivery is prioritized to hemoglobin in erythrocytes (RBC). Iron deficiency (ID) during pregnancy can cause congenital ID, i.e.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!