Perkembangan Terapi Zat Besi Intravena dari Masa ke Masa

-, Henny

Cermin Dunia Kedokteran
Vol 42, No 8 (2015): Nutrisi

Zat besi merupakan suatu makromineral esensial yang sangat dibutuhkan untuk sintesis eritrosit. Anemia defisiensi besi dapat ditemukan bersamaan dengan anemia pada penyakit ginjal kronik. Satu-satunya terapi efektif untuk anemia defisiensi besi adalah penggantian zat besi, baik dari makanan maupun dari suplemen. Suplemen zat besi intravena lebih efektif daripada zat besi oral. Sediaan zat besi intravena iron dextran sering dikaitkan dengan efek samping. Sediaan ferric gluconate masih terkendala masalah toksisitas pada anak. Iron sucrose, sediaan zat besi intravena yang tergolong stabil, profil keamanannya cukup baik dibandingkan sediaan-sediaan sebelumnya; namun diduga dapat mencetuskan aterosklerosis. Ferumoxytol adalah sediaan zat besi intravena dengan waktu paruh cukup panjang meskipun pencapaian konsentrasi puncaknya cepat; dapat mengintervensi pemeriksaan magnetic resonance imaging (MRI). Sediaan zat besi intravena terbaru, yaitu ferric carboxymaltose, dianggap sediaan dengan pendosisan paling nyaman (seminggu sekali), terbukti efektivitasnya setara dengan sediaan zat besi intravena lain. Keragaman sediaan zat besi intravena memungkinkan pilihan sesuai kebutuhan pasien, kondisi kesehatan yang menyertai, dan ketersediaan.Iron is a macromineral which is essentially needed for synthesis of red blood cells Iron deficiency anemia may be found in patients with chronic kidney disease. The only effective therapeutic approach for iron deficiency anemia is iron replacement therapy, either in food or in supplement form. Intravenous iron supplementation is more effective than oral iron supplementation. Iron dextran is often associated with frequent adverse effects. Ferric gluconate, has more convenient dose schedule, but associated with high toxicity in children. Iron sucrose, an intravenous iron known for its stability, has better safety profile, but is considered to be atherogenic. Ferumoxytol is an intravenous iron, has long half-life but quick to reach peak concentration, interferes magnetic resonance imaging (MRI) examination. The latest intravenous iron, ferric carboxymaltose, is still considered as the most convenient (with schedule of once a week), and has been proven to be as effective as the other intravenous iron forms. These various forms of intravenous iron enables clinicians to select intravenous iron suited for their patients' needs, their medical conditions, and availability.