NDT Advance Access published online on August 5, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl419
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Cantonal Hospitals of Walenstadt, Switzerland
* To whom correspondence should be addressed. Background. Haemodialysis patients need sustained treatment with intravenous iron because iron deficiency limits the efficacy of recombinant human epoetin therapy in these patients. However, the optimal intravenous iron maintenance dose has not been established yet. Methods. We performed a prospective multicentre clinical trial in iron-replete haemodialysis patients to evaluate the efficacy of weekly low-dose (50 mg) intravenous iron sucrose administration for 6 months to maintain the iron status, and to examine the effect on epoetin dosage needed to maintain stable haemoglobin values in these patients. Fifty patients were enrolled in this prospective, open-label, single arm, phase IV study. Results. Forty-two patients (84%) completed the study. After 6 months of intravenous iron sucrose treatment, the mean ferritin value showed a tendency to increase slightly from 405 ± 159 at baseline to 490 ± 275 µg/l at the end of the study, but iron, transferrin levels and transferrin saturation did not change. The haemoglobin level remained stable (12 ± 1.1 at baseline and 12.1 ± 1.5 g/dl at the end of the study). The mean dose of darbepoetin alfa could be reduced from 0.75 to 0.46 µg/kg/week; epoetin alfa was decreased from 101 to 74 IU/kg/week; and the mean dose of epoetin beta could be reduced from 148 to 131 IU/kg/week at the end of treatment. Conclusions. A regular 50 mg weekly dosing schedule of iron sucrose maintains stable iron stores and haemoglobin levels in haemodialysed patients and allows considerable dose reductions for epoetins. Low-dose intravenous iron therapy may represent an optimal approach to treat the continuous loss of iron in dialysis patients.
Received March 10, 2006
Accepted June 19, 2006
Original Article
Weekly low-dose treatment with intravenous iron sucrose maintains iron status and decreases epoetin requirement in iron-replete haemodialysis patients
Daniela Schiesser 1, Isabelle Binet 2, Dimitrios Tsinalis 2, Michael Dickenmann 3, Gérald Keusch 4, Markus Schmidli 5, Patrice M. Ambühl 6, Liudmila Lüthi 6, and Rudolf P. Wüthrich 6 *
2 Cantonal Hospitals of St Gallen, Switzerland
3 Cantonal Hospitals of Basel, Switzerland
4 Cantonal Hospitals of Waid City Hospital, University Hospitals, Switzerland
5 Cantonal Hospitals of Herisau, Switzerland
6 Cantonal Hospitals of Zürich, Switzerland
Rudolf P. Wüthrich, E-mail: rudolf.wuethrich{at}usz.ch
Abstract 
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. Kapoian, N. B. O'Mara, A. K. Singh, J. Moran, A. R. Rizkala, R. Geronemus, R. C. Kopelman, N. V. Dahl, and D. W. Coyne Ferric Gluconate Reduces Epoetin Requirements in Hemodialysis Patients with Elevated Ferritin J. Am. Soc. Nephrol., February 1, 2008; 19(2): 372 - 379. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Wang, G. Geraci, M. K. Kuhlmann, N. W. Levin, and G. J. Handelman Chemical reactions of vitamin C with intravenous-iron formulations Nephrol. Dial. Transplant., January 1, 2008; 23(1): 120 - 125. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Shaldon The use of IV iron in the treatment of anaemia of ESRD patients on maintenance haemodialysis: an historical and personal view Nephrol. Dial. Transplant., January 1, 2007; 22(1): 23 - 25. [Full Text] [PDF]
|
|