Low Dose Intravenous Iron Sucrose Maintenance Therapy in Hemodialysis Patients with Adequate Iron Storage

Park, Jongha; Choi, Jung; Park, Tae Jin; Chang, Jai Won; Yang, Won Seok; Kim, Soon Bae; Lee, Sang Koo; Park, Su Kil; Park, Jung Sik

Abstract

BACKGOUND: In addition to recombinant human erythropoietin (rHuEPO) adequate iron replacement is essential to treatment of anemia in hemodialysis (HD) patients, and intravenous iron therapy has been recommended recently. But, low dose (100-200 mg/ month) intravenous iron sucrose regimen as a "maintenance therapy" in HD patients with adequate iron storage has not been established well.
METHODS
We included the 40 of HD patients with serum ferritin of 200-500 ng/mL receiving rHuEPO therapy. During 4 months of study period, 100-200 mg/month of iron sucrose was administrated. rHuEPO doses were titrated to maintain target hematocrit (Hct) of 30%. To evaluate efficacy of iron sucrose, we compared serum ferritin, TSAT and rHuEPO requirements before and after iron sucrose therapy.
RESULTS
Thirty-nine patients [mean age 61+/-13 yrs, M:F=20:19] completed this study. After low dose intravenous iron sucrose maintenance therapy, serum ferritin and TSAT significantly increased (370+/-84 vs. 518+/-155 ng/mL, p<0.001 and 26.0+/-9.7 vs. 31.1+/-11.8%, p=0.046). Mean weekly rHuEPO dose didn't significantly decrease (5,756+/-2,295 vs. 5,474+/-2,237 IU/week, p=0.441) but ERI significantly decreased (3.86+/-2.19 vs. 3.20+/-1.70 IU/week/kg/%, p=0.021). No iron overload defined as serum ferritin >800 ng/mL was observed during the study.
CONCLUSION
Low dose intravenous iron sucrose maintenance therapy is effective and safe in the HD patient receiving rHuEPO therapy with adequate iron storage.