Intravenous iron infusion

Intravenous (IV) iron infusion is a therapy in which a combination of iron and saline solution is delivered directly into the bloodstream through a vein, in patients suffering iron deficiency, iron-deficiency anaemia and chronic kidney disease. IV iron infusions are recommended when oral iron supplementation fails to adequately restore iron and haemoglobin levels in the blood. The intravenous method is a fast and effective way of delivering iron throughout the body, used as iron can be administered instantly rather than gradually over time. IV iron infusions first came about in the early twentieth century. The earliest intravenous iron solution was ferric hydroxide. Treatment was only recommended in extreme conditions due to its association with toxicity. Ferric hydroxide was identified as toxic because it was found to release free bioactive iron when injected intravenously, increasing risk of infection. Further research led to the development of iron saccharide in 1947. Testing concluded iron saccharide to be safer and more effective for anaemic patients seeking a IV infusion. Later, in 1954 the use of iron dextran became popular and a product called Imferon emerged. Release of free bioactive iron was minimised by covering the iron oxide core in large dextran molecules. Patients responded well to Imferon, a rapid increase in haemoglobin and iron levels was observed and researchers saw a low incident of side effects compared to previous iron solutions. Large dextran molecules did however have a connection to anaphylaxis. As such an infusion of Imferon was not recommended to patients with a history of allergic reactions, and a test dose was required for all other patients undergoing treatment. In 1980 a study was completed in the United States on the clinical use of intravenous iron infusions. Four hundred and seventy-one patients with iron deficiency were treated with IV iron infusions at varying doses. Three patients suffered anaphylactic reactions such as drop in blood pressure, discolouration of the skin, shortness of breath and fainting.