Non-transferrin bound iron, cytokine activation and intracellular reactive oxygen species generation in hemodialysis patients receiving intravenous iron dextran or iron sucrose.

Reading of this article is strongly recommended, especially for researchers with IV iron. It is also my (polemic) opinion that the article strongly supports the notion that the switch to iron sucrose in patients on dialysis and for a whole host of conditions associated with iron deficiency was ill-considered. This is one of several papers, along with those of Agrawal et al., Zager et al. and previous papers by this author, that support the potential renal toxicity (not studied in prospective trials) of iron sucrose and, to a nearly equal degree, of ferric gluconate, compared to iron dextran. Furthermore, the recent abstract from Harvard by Okum et al. supports the improved safety of low-molecular-weight iron dextran compared to iron sucrose, ferric gluconate and high-molecular-weight iron dextran.

– Michael Auerbach