Dark-Colored Urine Following Iron Sucrose Infusion
Known Adverse Effects of Iron Sucrose
- Iron sucrose has a well-established safety profile with relatively few serious adverse effects compared to other intravenous iron preparations, according to the National Kidney Foundation 1, 2
- Common adverse effects include hypotension and flushing (rare), abdominal cramps (rare, particularly when co-administered with ACE inhibitors), and arthralgias and myalgias (acute rather than delayed), as reported by the American Journal of Kidney Diseases 1, 2
- The American College of Physicians recommends monitoring for these adverse effects, and notes that no reports of dark-colored urine are mentioned in the clinical practice guidelines for anemia management in chronic kidney disease patients receiving iron sucrose 1, 2
Differential Considerations for Dark Urine
- Underlying kidney disease may cause urine color changes in patients receiving iron therapy, as noted by the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines 3
- Medication interactions might interact with iron sucrose or independently cause urine discoloration, according to the American College of Clinical Pharmacy 2
- Dehydration may cause concentrated urine that appears darker, as reported by the European Society of Gastrointestinal Endoscopy 4
Clinical Approach to Dark Urine After Iron Infusion
- Evaluate kidney function (creatinine, BUN) to assess for underlying kidney disease, as recommended by the National Institute of Diabetes and Digestive and Kidney Diseases 3
- Review medication list for other potential causes of urine discoloration, as suggested by the American Society of Health-System Pharmacists 4
- Ensure adequate hydration status to prevent concentrated urine, as advised by the European Society of Clinical Nutrition and Metabolism 4