title: Iron availability is transiently improved by intravenous iron medication in patients on chronic hemodialysis.
abstract: Iron deficiency is common in hemodialysis patients, particularly if they are on recombinant human erythropoietin (rHuEPO) therapy. Ten anemic patients (hemoglobin concentration 89 +/- 2.2 g/l, mean +/- SEM) on hemodialysis with either storage (serum-ferritin < 60 mg/l) and/or functional (S-transferrin saturation < or = 17%) iron deficiency were followed for 5 weeks. During the first 3 weeks they were given 100 mg of iron dextran on 10 consecutive dialysis sessions. Half of the patients were concomitantly treated with rHuEPO. Iron therapy resulted in a rapid elevation in serum transferrin iron saturation from 11 +/- 1.5% to 80 +/- 7.2% (p < 0.0001), but it decreased to pre-treatment levels within 2 weeks after discontinuation of iron therapy. Serum ferritin concentration increased from 157 +/- 73 mg/l to 434 +/- 105 mg/l during iron therapy (p < 0.0001). In spite of this only 4 patients (2 rHuEPO treated) responded and had a hemoglobin increment > 10 g/l. In the whole group serum transferrin receptor (TfR) levels remained stable, but increased after the cessation of iron dextran only in the rHuEPO treated patients (p < 0.01). In the responders the TfR levels were higher during iron therapy than in the nonresponders (p < 0.02). In an attempt to explain the resistance to iron therapy, serum concentrations of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha) and interleukin-1b (IL-1b) were also analyzed.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Fourth Department of Medicine, University of Helsinki, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Rosenlöf
authors.forename: S M
authors.initials: SM
authors.lastname: Kivivuori
authors.forename: C
authors.initials: C
authors.lastname: Grönhagen-Riska
authors.forename: A M
authors.initials: AM
authors.lastname: Teppo
authors.forename: M A
authors.initials: MA
authors.lastname: Slimes
mesh_terms: D000368:Aged; D000747:Anemia, Hypochromic / Q000188:drug therapy; D001682:Biological Availability; D002097:C-Reactive Protein / Q000032:analysis; D004921:Erythropoietin / Q000008:administration & dosage; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007275:Injections, Intravenous; D007375:Interleukin-1 / Q000097:blood; D007501:Iron / Q000008:administration & dosage* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D006435:Renal Dialysis / Q000009:adverse effects; D014168:Transferrin / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D006454:Hemoglobins; D007375:Interleukin-1; D011994:Recombinant Proteins; D014168:Transferrin; D014409:Tumor Necrosis Factor-alpha; D004921:Erythropoietin; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron