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CC BY-NC-ND 4.0 · Dtsch Med Wochenschr 2019; 144(14): 969-977
DOI: 10.1055/a-0810-8596
Review
© Georg Thieme Verlag KG Stuttgart · New York

Intravenöse Eisensubstitution bei chronischer Erkrankung – bei wem, wann und wie?

Intravenous Iron Substitution in Chronic Disease – in Whom, When and How?
Patrick Biggar
1   Klinik für Nephrologie, Klinikum Coburg GmbH
,
Peter Langguth
2   Institut für Pharmazie und Biochemie, Abteilung für Pharmazeutische Technologie und Biopharmazie, J. G. Universität Mainz
,
Pierre-Alexandre Krayenbühl
3   Spital Linth, Schweiz
,
Vincent Brandenburg
4   Klinik für Kardiologie und Nephrologie, Rhein-Maas Klinikum
› Author Affiliations
Further Information

Publication History

Publication Date:
16 July 2019 (online)

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Zusammenfassung

In den letzten Jahren konnten wesentliche Fortschritte in der Erkennung und Behandlung des Eisenmangels erzielt werden, deren Ergebnisse auch für viele Fachgebiete und insbesondere mit Patienten mit chronisch-entzündlichen Erkrankungen relevant sind. Allerdings wird in der täglichen Praxis ein Eisenmangel vielfach nicht identifiziert und konsequent therapiert.

Ein Eisenmangel kann – auch bevor eine Anämie auftritt – die Lebensqualität einschränken und den Verlauf der Grunderkrankung beeinflussen. Bei Patienten mit chronischen Erkrankungen sollte der Eisenstatus regelmäßig erfasst werden. Gerade bei Patienten mit chronisch-entzündlichen Erkrankungen sind die derzeit verfügbaren oralen Eisenpräparate ineffizient, weil die Verträglichkeit eingeschränkt ist und die enterale Eisenaufnahme durch Inflammation eingeschränkt sein kann. Deshalb empfehlen verschiedene Leitlinien hier eine intravenöse Eisensubstitution.

Abstract

In recent years, considerable progress has been made in the detection and treatment of iron deficiency. The results are also relevant for many specialist areas and, in particular, for patients with chronic inflammatory diseases. In daily practice, iron deficiency is often neither identified nor consistently treated.

An iron deficiency can – even before anaemia occurs – reduce the quality of life and influence the course of the underlying disease. In patients with chronic diseases , the iron status should be monitored regularly. Especially, the currently available oral iron preparations for these patients are inefficient, because of the limitated tolerability and, furthermore, because of restricted enteral iron uptake due to inflammation. For this reason, various guidelines recommend intravenous iron substitution.

Schlüsselwörter

Eisenmangelanämie - chronisch-entzündliche Erkrankung - Eisenpräparate - intravenöse Eisensubstitution

Key words

iron deficiency anaemia - patients with chronic inflammatory diseases - iron preparations - intravenous iron substitution
 

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