Nephrology Dialysis Transplantation, Vol 13, Issue 11 2873-2876, Copyright © 1998 by Oxford University Press
C Jones, D Richardson, S Ayers, C Newstead, E Will and A Davison
Introduction: Iron deficiency is commonly encountered
in haemodialysis (HD) patients and may be overcome by i.v. therapy. We have
examined the percentage hypochromic red cells (%HRC) for predicting
response to i.v. iron in subjects with a low serum ferritin.
Methods: Prospective study of i.v. iron saccharate
(trivalent iron 200 mg/week for 8 weeks) in anaemic (Hb <10 g/dl) HD
patients with serum ferritin <100 &mgr;g/l despite oral iron
therapy. Response to i.v. iron was assessed by comparing Hb at 0 and 8
weeks according to %HRC at baseline (0-3%, 4-9%, ⩾10%). Results are
mean±1 SD. Results: For all subjects
(n=82), Hb and ferritin increased between 0 and 8 weeks (8.9±1.0
to 10.1±1.4, P<0.0001; 55±24 to
288±126, P<0.0001). Patients were stratified into three
groups according to %HRC at baseline (0-3%, 4-9%, ⩾10%). Hb
increased significantly in all three groups. The mean increase in Hb was
greater (0-3%, 0.6±1.2; 4-9%, 1.2±1.0; ⩾10%,
1.6±1.4; P=0.02) and the proportion of patients showing a
⩾1 g/dl increase in Hb was greater (0-3%, 27%; 4-9%, 47%;
⩾10%, 67%; P=0.02) in those with the largest %HRC pre-treatment.
Conclusion: Intravenous iron therapy is effective in
improving Hb in anaemic HD patients with a low ferritin. However, the
magnitude of this response and the proportion of patients responding is
related to the percentage hypochromic red cells prior to treatment.
Key words: haemodialysis; intravenous iron; red cell
hypochromia; erythropoietin
ORIGINAL ARTICLES
Percentage hypochromic red cells and the response to intravenous iron therapy in anaemic haemodialysis
Department of Renal Medicine, St James's University Hospital, Leeds LS9 7TF, UK; Corresponding author
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