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Experimental renal failure and iron overload: a histomorphometric study in rat tibia.

Renal failure (RF) is a serious disease of relatively high incidence, known to cause bone alterations. RF patients frequently suffer anemia, which is usually treated with iron. Given that iron overload inhibits bone formation, the aim of the present study was to evaluate the effect of iron on the subchondral bone of rat tibiae, using a model of renal failure. Male Wistar rats were subjected to experimental nephrectomy in order to induce renal failure and to iron overload by daily intraperitoneal injections of 88 mg/kg body weight of iron-dextran for 16 days. Tetracyclines were injected intraperitoneally to evaluate dynamic parameters of bone. Undecalcified histological sections of the tibiae were obtained. Serum urea, creatinine, and paratohormone (PTH) levels were evaluated 30 days after the onset of the experiment. Static and dynamic histomorphometric measurements were performed. Iron overload modified the response of the animals with renal failure: a reduction in bone forming activity compatible with adynamic bone disease and a decrease in peritrabecular fibrosis were observed. Our results suggest that iron is yet one more factor involved in the imbalance in bone metabolism typically found in renal failure patients treated with iron, rendering diagnosis and treatment of bone disease in these patients more complex.

Animals↗

Ferastral in the treatment of patients with inflammatory anaemia.

An investigation has been performed with a new parenteral iron preparation, iron-poly-(sorbitol-gluconic acid) complex (Ferastral) in the treatment with iron deficiency anaemia associated with inflammatory diseases, mainly rheumatoid arthritis. Fifteen moderately anaemic patients entered into the trial. These patients constituted a special group in whom the MCHCs were subnormal. Observations were made concerning the occurrence of side-effects. Particular attention was paid to those-side-effects which are known to be associated with the use of parenteral iron preparations in the treatment of rheumatoid subjects. Ferastral was administered by intramuscular by intramuscular injection. The single doses given on any one occasion varied from a minimum of 100 mg to a maximum of 500 mg, divided into two separate injections. The results of therapy, measured at eight weeks, showed significant increases in haemoglobin concentrations. Increases in erythrocyte count, MCHC and serum-iron concentration were also found. There were no signs of acute toxic effects with Ferastral and in no patient was there exacerbation of arthritis as has been previously reported with iron-dextran.

Anemia, Hypochromic↗