Therapy of iron-deficiency anemia in geriatric practice

O.E. Kropova¹, T.S. Shindina¹, M.L. Maximov^2,3, A.S. Galyavich⁴, E.B. Alexandrova¹

¹Outpatient Clinic No. 5, Moscow

²Kazan State Medical University, the branch of the Russian Medical Academy of Continuous Professional Education, Kazan

³Pirogov Russian National Research Medical University, Moscow

⁴Kazan State Medical University, Kazan 

The review examines the causes, pathogenesis, as well as issues of diagnosis and correction of iron-deficiency anemia (IDA) in gerontological practice. IDA may have the pluricausal origin in patients of elderly and senile age. Systemic hypoxia caused by anemia worsens the course of concomitant diseases and affects life expectancy. Anemia is an independent factor of adverse prognosis in patients with chronic heart failure (CHF), while up to 70% of anemia cases in patients with CHF are iron-deficient. When diagnosing IDA, it is necessary to focus on the hemoglobin concentration, state indicators of red blood cells and iron metabolism in the body. The article describes methods to the IDA treatment in elderly and senile patients, taking into account the pharmacokinetics and pharmacodynamics of bivalent and trivalent iron medications for oral and parenteral administration. It is necessary to give preference to medications based on the trivalent iron(III)-hydroxide polymalt ose complex for enteral administration to minimize the frequency of adverse reactions. If there is no response to therapy with oral medications, it is indicated to use modern non-dextran intravenous iron medications in case of rapid correlation of IDA or iron deficiency before surgery.

Keywords: iron metabolism, iron-deficiency anemia, bivalent iron, trivalent iron, gerontology, anemia treatment, rational pharmacotherapy, polypragmasia, chronic heart failure, pharmacotherapy safety.

For citation: Kropova O.E., Shindina T.S., Maximov M.L. et al. Therapy of iron-deficiency anemia in geriatric practice. RMJ. 2020;9:59–64.