Aims: To conduct a 3-month prospective study to determine the optimal way for intravenous iron supplementation in hemodialysis (HD) patients with resistance to recombinant human erythropoietin (rHuEPO) therapy due to deficient iron storage. Methods: Thirty-five HD patients with iron deficiency were divided into three groups: (1) patients receiving an intravenous infusion of 40 mg of iron during the first ten HD sessions (n = 12); (2) patients receiving 40 mg of iron injected once a week for 10 weeks (n = 12), and (3) patients without any iron supplementation (n = 11). The rHuEPO dosage was adjusted to maintain hemoglobin levels >10.0 g/dl, and the degree of anemia was assessed 3 months later. Results: In group 1, the hemoglobin levels were significantly increased after 4 weeks and remained increased until the end of the study (p < 0.01). In group 2, the hemoglobin levels were gradually increased until the end of the study (p < 0.01). There was no difference in the final hemoglobin values between both groups. The rHuEPO dosage was significantly decreased from 131 ± 18 to 90 ± 17 U/kg/week in group 1 (p < 0.01), but could not be changed in group 2 during the observation period despite a similar elevation of the serum ferritin level. In group 3, the rHuEPO doses were rather increased at the end of the study (p < 0.05). Conclusion: Aggressive iron supplementation for the short term may be effective to restore rHuEPO hyporesponsiveness in HD patients with functional iron deficiency.

Keywords:
Hemodialysis, Erythropoietin, Iron, Resistance, rHuEPO
1.
NKF-DOQI Clinical Practice Guidelines for the Treatment of Anemia of Chronic Renal Failure. Am J Kidney Dis 1997;30(suppl 3):S192–S240.
2.
Besarab A, Kaiser JW, Frinak S: A study of parental iron regimens in hemodialysis patients. Am J Kidney Dis 1999;34:21–28.
3.
Auerbach M, Winchester J, Wahab A, Richards K, McGinley M, Hall F, Anderson J, Briefel G: A randomized trial of three iron dextran infusion methods for anemia of erythropoietin treated dialysis patients. Am J Kidney Dis 1998;31:81–86.
4.
Saltissi D, Sauvage D, Westhuyzen J: Comparative response to single or divided doses of parental iron for functional iron deficiency in hemodialysis patients receiving erythropoietin (EPO). Clin Nephrol 1998;49:45–48.
© 2001 S. Karger AG, Basel
2001
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