Letter to the Editor

Editor, – I read your brief few paragraphs on iron sucrose (Aust Prescr 2005;28:49-51) and felt the need to point out a few things:

  • It states in the second paragraph that the sucrose is eliminated in the urine. As prescribing is restricted to patients having dialysis, I doubt very much whether this is true. Most dialysis patients have little or no urine and certainly do not manage to excrete anything worthwhile in their urine.
  • The last paragraph regarding safety and efficacy reveals the blindness of Australian authorities. Iron sucrose has been used for over 30 years in more than 50 countries around the world and has a safety record far superior to the currently available iron polymaltose.

The prescribing should be limited to 'dialysis' patients, not just 'haemodialysis' patients - 23% of dialysis patients are peritoneal dialysis patients. Indeed 50+% of patients starting dialysis have commenced erythropoietic agents (legally, and according to guidelines) before they need dialysis. This group will also benefit from iron sucrose so 'chronic renal failure' is a more appropriate indication.

Peter Kerr
Associate Professor
Deputy Director, Nephrology
Monash Medical Centre
Clayton, Vic.

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