Usefulness of Intravenous Iron Supplement During Recombinant Human Erythropoietin(rHuEPO) Therapy in Hemodialysis(HD) Patients.
- Author:
Kwang Jae PARK
1
;
Jae Yeong KANG
;
Jae Won CHOE
;
Won Seok YANG
;
Soon Bae KIM
;
Jung Sik PARK
;
Chang Gi HONG
Author Information
1. Department of Internal Medicine, College of Medicine, University of Ulsan, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
End stage renal disease;
Anemia;
Erythropoietin;
Intravenous iron therapy;
Iron chondroitin sulfate
- MeSH:
Anemia;
Biological Availability;
Chondroitin;
Dextrans;
Erythropoietin;
Ferritins;
Humans*;
Iron*;
Kidney Failure, Chronic;
Transferrin
- From:Korean Journal of Nephrology
1997;16(4):753-759
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Compared with iron dextran, iron chondroitin sulfate(ICS) is much cheaper and has better bioavailability. To evaluate the efficacy and safety of ICS in maintenance HD patients, i.v. ICS was given to 37 HD patients [20 M, 17 F, median age 51 years, median duration of HD 21 months] whose ferritin(Fer)< 100microgram/L or transferrin saturation(TFS) <20% [Group I , 12 M, 10 F] or Hb<9.0g/dL in spite of increased rHuEPO dose, Fer>or=100microgram/L and TFS>or=20% [Group II, 8 M, 7 F]. The patients had taken oral iron [227+/-73mg/day(mean+/-SD)] before this study. All patients received 120mg i.v. ICS weekly for 1 month. Then, ICS dosage was adjusted to 40-120mg/week depending on Hb, Fer and TFS in the following 3 months. Hb, Fer, TFS, rHuEPO dose and side effects were monitored monthly. The results were as follows : 1) I.v. iron therapy produced a significant rise in Hb(8.3+/-0.9g/dL to 9.7+/-0.9g/dL; P<0.01), a significant reduction in rHuEPO dose(95+/-50U/kg/wk to 69+/-28U/kg/wk; P<0.05), a significant increase in serum ferritin levels(162+/-149microgram/L to 472+/-255microgram/L; P<0.01) and TFS(24+/-13% to 41+/-18%; P<0.05). 2) In group 1, i.v. iron therapy produced a significant rise in Hb(8.5+/-1.1g/dL to 9.9+/-0.9g/dL; P< 0.01), a significant reduction in rHuEPO dose(87+/-45U/kg/wk to 69+/-27U/kg/wk; P<0.05), increased serum ferritin levels(90+/-48microgram/L to 379+/-186microgram/L; P<0.01) and TFS(18+/-9% to 36+/-16%; P<0.05). 3) In group 2, i.v. iron therapy produced a significant rise in Hb(8.1+/-0.6g/dL to 9.3+/-0.9g/dL; P<0.01), a significant reduction in rHuEPO dose(108+/-55U/kg/ wk to 69+/-31U/kg/wk; P<0.05) and increased serum ferritin levels(274+/-185microgram/L to 602+/-287microgram/L; P< 0.01) with a tendency of increase in TFS(35+/-13% to 41+/-18%; P=0.06). 4) No significant side effect was observed. 5) An annual cost reduction of 221 US dollars per patient was expected. In conclusion, ICS is an effective and safe intravenous iron preparation in HD patients.
