title: Efficacy of bolus intravenous iron dextran treatment in peritoneal dialysis patients receiving recombinant human erythropoietin.
abstract: The efficient use of recombinant human erythropoietin (rHuEPO) requires adequate body stores of iron. In peritoneal dialysis (PD) patients, iron replacement is most commonly administered orally. In this study, we prospectively followed 7 stable PD patients following bolus intravenous infusion of 1 g iron dextran in an outpatient setting. At 12 weeks, significant (p < 0.05) increments in mean hematocrit from 29.13% to 34.85%, transferrin saturation from 10.15% to 29.33%, serum iron from 27.38 to 67.00 micrograms/dL, and serum ferritin from 150.30 to 331.40 ng/mL were observed. Post-treatment, there was less requirement of rHuEPO, and at six months there was a 26% reduction in the mean weekly subcutaneous rHuEPO dose. At 12 weeks, serum albumin increased significantly from 3.50 to 3.76 g/dL (p < 0.05). There was no abnormality in any of the measured liver function tests. No patient developed an adverse or allergic reaction. We concluded that bolus intravenous infusion of iron dextran is an effective and well-tolerated method of repleting iron stores, and will allow a more efficient and economic use of rHuEPO in PD patients.
authors.affiliation: Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University-College of Medicine, Hershey, USA.
authors.forename: N
authors.initials: N
authors.lastname: Ahsan
authors.forename: J A
authors.initials: JA
authors.lastname: Groff
authors.forename: M A
authors.initials: MA
authors.lastname: Waybill
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D005293:Ferritins / Q000378:metabolism; D006400:Hematocrit; D006801:Humans; D007262:Infusions, Intravenous; D007501:Iron / Q000097:blood; D007505:Iron-Dextran Complex / Q000008:administration & dosage*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011446:Prospective Studies; D011994:Recombinant Proteins; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D011994:Recombinant Proteins; D012709:Serum Albumin; D004921:Erythropoietin; D007505:Iron-Dextran Complex; D005293:Ferritins; D007501:Iron