Eisensupplementation bei Patienten mit chronisch-entzündlicher Darmerkrankung: Empfehlungen zur praxisnahen Vorgehensweise

Zusammenfassung

Der Eisenmangel ist die vorherrschende Ursache einer Anämie. Vor allem bei Patienten mit einer chronisch-entzündlichen Darmerkrankung (CED) spielt die Eisenmangelanämie eine große Rolle und stellt die häufigste extraintestinale Manifestation und CED-assoziierte systemische Komplikation dar. Das Vorliegen einer Anämie führt bei Patienten mit einer CED zu einer Reduktion der Lebensqualität und ist assoziiert mit Einschränkungen der körperlichen, emotionalen und kognitiven Funktion. Darüber hinaus geht sie mit einer erhöhten Hospitalisierungsrate einher. Aus diesem Grund ist die Eisensupplementation von besonderer Bedeutung. Zur Behandlung des Eisenmangels werden orale und intravenöse Eisenpräparate verwendet. Aufgrund mangelnder Resorptionsfähigkeit und gastrointestinalen Nebenwirkungen der oralen Substitution rückt die intravenöse Supplementierung immer mehr in den Vordergrund. Gegenüber der intravenösen Verabreichung bestehen allerdings immer noch gewisse Bedenken.

Mithilfe dieses Reviews wollen wir das Thema der Eisensubstitution bei Patienten mit einer CED aufgreifen, gegenwärtige Leitlinienempfehlungen diesbezüglich zusammenfassen, sowie eine praxisnahe Vorgehensweise an die Hand geben.

Abstract

Iron deficiency is the predominant cause of anemia. Iron deficiency anemia plays a major role, especially in patients with inflammatory bowel disease (IBD), and is the most common extraintestinal manifestation and IBD-associated systemic complication. The presence of anemia leads to a reduction in quality of life in patients with IBD associated with limitations in physical, emotional, and cognitive function. In addition, it is associated with an increased hospitalization rate. For this reason, iron supplementation is of particular importance. Oral and intravenous iron supplements are used to treat iron deficiency. Due to the lack of absorption and gastrointestinal side effects of oral substitution, intravenous supplementation is becoming increasingly important. However, there are still certain concerns about intravenous administration.

With the help of this review, we want to address the topic of iron substitution in patients with IBD, summarize current guideline recommendations, and provide a practical approach.

Schlüsselwörter

Chronisch-entzündliche Darmerkrankung - Anämie - Eisenmangel - Supplementation - extraintestinale Manifestation

Keywords

Inflammatory bowel disease - anemia - iron deficiency - iron supplementation - extraintestinal manifestation

Publikationsverlauf

Eingereicht: 19. Oktober 2023

Angenommen nach Revision: 18. Februar 2024

Artikel online veröffentlicht:
24. April 2024

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