Acceleration of iron utilization after intravenous iron administration during activated erythropoiesis in hemodialysis patients: a randomized study.
Study Goal
The researchers aimed to evaluate the effect of different timings of intravenous iron administration during erythropoiesis activated by CERA on reticulocyte iron uptake in hemodialysis patients.
Results Summary
Iron administration in the first week after CERA administration significantly increased reticulocyte iron uptake compared to administration in the third week, which showed only a tendency toward improvement. Early iron supplementation enhanced the efficacy of CERA during highly active erythropoiesis.
Population
Hemodialysis patients
Effective Dosage
40 mg intravenous elemental iron doses at all three hemodialysis sessions in the first or third week after CERA administration
Duration
3 weeks (intervention timing varied by group)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
CERA administration | increase | reticulocyte count | hemodialysis patients | peaking at day 7 | increased | #1 |
40 mg intravenous elemental iron doses at all three hemodialysis sessions in the first week (IW1 group) | increase | Ret-He | hemodialysis patients | - | observed changes in Ret-He were higher | #2 |
40 mg intravenous elemental iron doses at all three hemodialysis sessions in the first week (IW1 group) | increase | total reticulocyte hemoglobin | hemodialysis patients | - | Increases in total reticulocyte hemoglobin were higher | #3 |
40 mg intravenous elemental iron doses at all three hemodialysis sessions in the third week (IW3 group) | increase | total reticulocyte hemoglobin | hemodialysis patients | - | only tendency toward greater total reticulocyte hemoglobin | #4 |
Intravenous iron supplementation in the first week of CERA administration | increase | reticulocyte iron uptake | hemodialysis patients | - | increases | #5 |
iron supplementation in the third week | no change | reticulocyte iron uptake | hemodialysis patients | - | does not | #6 |
This study aimed to evaluate the effect of different timings of iron administration during erythropoiesis activated by continuous erythropoietin receptor activator (CERA) on reticulocyte iron uptake in hemodialysis patients. In total, 110 patients were randomized to receive 40 mg intravenous elemental iron doses at all three hemodialysis sessions in the first week (IW1 group: n = 57) or in the third week (IW3 group: n = 53) after CERA administration. Following CERA administration at day 0, reticulocyte count increased, peaking at day 7. At days 7 and 14, the observed changes in Ret-He were higher in the IW1 group than in the IW3 group. Increases in total reticulocyte hemoglobin at day 7 were higher in the IW1 group than in the IW3 group. In contrast, there was only tendency toward greater total reticulocyte hemoglobin after iron administration in the third week in the IW3 group. Intravenous iron supplementation in the first week of CERA administration increases reticulocyte iron uptake; however, iron supplementation in the third week does not. The findings indicate that iron should be intravenously administered to increase the efficacy of CERA within 1 week of CERA administration during highly active erythropoiesis.