Iron and PN

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For those living with short bowl syndrome, Crohn’s disease, cancer, dysmotility, or other diseases, home parenteral nutrition is a constant, and life sustaining treatment. Many patients with these conditions report low levels of iron. This deficiency is typically due to blood losses and malabsorption. The iron deficiency usually persists in those receiving home parenteral nutrition mostly due to blood losses. Despite this common deficiency, iron in not usually added to PN solutions. This omission is because of the relation to anaphylaxis and other acute reactions that often occur.
Some studies have shown that iron dextran can be added to PN solutions to safely meet daily needs. One such study looked at 185 patients receiving long-term PN at the Mayo Clinic. 32.4% of participants had iron deficient anemia while on PN. The patients were given iron as an infusion, added iron dextran in their PN, or both methods. Those who received the intravenous infusion of iron showed a significant increase in iron status. This study suggests that those who are at risk for iron deficient anemia while on long term PN should consider an infusion of iron.

Hwa Y L, Rashtak A, Kelly D G, Murray J A. Iron deficiency in long-term parenteral nutrition therapy. Jpen-Parenter Enter. 2015;40(6);869-876. DOI: 10.1177/0148607115587329.

SG

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