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Kidney Week

Abstract: TH-PO243

Effect of Intravenous Ferumoxytol on Serial Platelet Counts in CKD Patients with Iron Deficiency Anemia

Session Information

Category: Anemia and Iron Metabolism

  • 202 Anemia and Iron Metabolism: Clinical

Authors

  • Le, Terry, LSU Shreveport School of Medicine, Shreveport, Louisiana, United States
  • Chundru, Vittal, LSU Shreveport School of Medicine, Shreveport, Louisiana, United States
  • Dossabhoy, Neville R., LSU Shreveport School of Medicine, Shreveport, Louisiana, United States
Background

Iron deficiency often leads to reactive thrombocytosis; theoretically, its correction should lead to a lowering of the platelet count (PLT). Only a few studies have investigated this aspect, with some showing a reduction in PLT, whereas others did not. We investigated the effect of iron repletion with intravenous (IV) ferumoxytol (Fm) on serial PLT counts in CKD patients with iron deficiency anemia (IDA).

Methods

We conducted a retrospective chart review, including all patients with CKD and IDA who were treated with IV ferumoxytol at our medical center during a 24-month period. Patient demographics were recorded, as were baseline laboratory values for creatinine, eGFR, hemoglobin (Hgb), hematocrit (HCT), iron, transferrin saturation, ferritin and PLT. The serial counts for Hgb, HCT and PLT continued to be recorded at 1, 2, 3, 4, 6, 8, 12 and 16 weeks after the Fm dose. If data was unavailable at the exact time point, the nearest date was used if within a week.

Results

A total of 264 doses of IV ferumoxytol (each 510 mg) were given in 119 patients with age 57+13 years, Creatinine 3.1+1.5 mg/dL, eGFR 26+12 mL/min, Hgb 10.2+1.3 g/dL, T-sat 16.5+6 % and PLT 242+85. All CKD stages were represented in the study sample. Hgb and Fe stores improved post-dose. The change in post-dose PLT over time is depicted in the table below. In fact, PLT were reduced compared to baseline throughout the 16-week period of follow-up, reaching statistical significance at weeks 3, 6, 8, 12 and 16.

Conclusion

Correction of iron deficiency significantly lowered PLT in CKD patients with IDA who received IV ferumoxytol. This finding stands in contrast to some previous evidence that PLT counts were not significantly reduced with IV iron dextran used as total dose infusion. Our findings may help guide choice of IV iron therapy, given the possibility that increased PLT in the short-term post-dose period may contribute to the thrombotic events noted in clinical trials of erythropoiesis stimulating agents in CKD patients.