Very low doses of direct intravenous iron in each session as maintenance therapy in hemodialysis patients.
Study Goal
The researchers aimed to determine if a 20 mg dose of IV iron administered at the end of each hemodialysis session was more effective than prior iron therapy in maintaining erythropoiesis activity and functional iron levels.
Results Summary
The study found no significant changes in reticulocyte count or CHr after four weeks of treatment, indicating maintained erythropoiesis activity and functional iron levels. Patients without prior iron therapy showed high functional iron levels but no increase in serum ferritin or hepcidin.
Population
36 hemodialysis patients, 23 of whom had prior IV iron maintenance therapy.
Effective Dosage
20 mg IV iron at the end of each hemodialysis session.
Duration
Four weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
20 mg dose of iron IV at the end of each session of HD as iron maintenance | no change | erythropoiesis activity (EA) levels | hemodialysis (HD) patients | - | keeps | #1 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | no change | functional iron (FI) levels | hemodialysis (HD) patients | - | keeps | #2 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | decrease | iron overload administered | hemodialysis (HD) patients | - | allows reducing | #3 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | decrease | iron stores markers | some patients | - | allows decreasing | #4 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | no change | reticulocyte count | 36 patients | 49.7 ± 23.8 × 10(3) before and 47.2 ± 17.2 × 10(3) after | showed | #5 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | no change | CHr | 36 patients | 34.8 ± 3.7 pg and 34.4 ± 3.5 pg | showed | #6 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | neutral | CHr with serum iron | 36 patients | r = 0.6 | showed an excellent correlation | #7 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | neutral | CHr with saturation transferrin | 36 patients | r = 0.49 | showed an excellent correlation | #8 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | no change | CHr with serum ferritin | 36 patients | r = 0.23 | that is not shown | #9 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | no change | CHr with hepcidin levels | 36 patients | r = 0.22 | that is not shown | #10 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | no change | C-Reactive Protein with reticulocyte count | 36 patients | - | There was not a correlation | #11 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | no change | C-Reactive Protein with CHr | 36 patients | - | There was not a correlation | #12 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | increase | FI levels | 13 patients who did not receive the iron prior to the study | - | showed high | #13 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | no change | serum ferritin | 13 patients who did not receive the iron prior to the study | - | showed not an increased | #14 |
20 mg dose of iron IV at the end of each session of HD as iron maintenance | no change | serum hepcidin levels | 13 patients who did not receive the iron prior to the study | - | showed not an increased | #15 |
BACKGROUND: Intravenous (IV) iron supplementation is widely used in hemodialysis (HD) patients to treat their periodic losses. However, the ideal dose and frequency is unknown. The goal of the study is to see if a 20 mg dose of iron IV at the end of each session of HD as iron maintenance is better than the iron prior therapy. We analyze the erythropoiesis activity (EA) and functional iron (FI) after four weeks of treatment. METHODS: In 36 patients, we measure reticulocyte count and content of hemoglobin reticulocyte (CHr) as EA and FI markers, respectively, before and after the treatment. Before the study, 23 patients received another different therapy with IV iron as maintenance therapy. RESULTS: Reticulocyte count: 49.7 ± 23.8 × 10(3) before and 47.2 ± 17.2 × 10(3) after the treatment (p= 0.51). The CHr: 34.8 ± 3.7 pg and 34.4 ± 3.5 pg, respectively, (p= 0.35), showing an excellent correlation with the other FI markers (serum iron r = 0.6; p = 0.001; saturation transferrin r = 0.49; p = 0.004); that is not shown with the serum ferritin (r = 0.23; p = 0.192) or the hepcidin levels (r = 0.22; p = 0.251). There was not a correlation between the C-Reactive Protein, reticulocyte count, and CHr. The 13 patients who did not receive the iron prior to the study showed high FI levels, but not an increased of the serum ferritin or the serum hepcidin levels. CONCLUSIONS: The administration of a small quantity of iron at the end of every HD session keeps the EA and the FI levels and allows reducing the iron overload administered and/or decreasing the iron stores markers in some patients.