title: Percentage hypochromic red cells and the response to intravenous iron therapy in anaemic haemodialysis patients.
abstract: BACKGROUND
  Iron deficiency is commonly encountered in haemodialysis (HD) patients and may be overcome by i.v. iron 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 microg/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%, > or = 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%, > or = 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; > or = 10%, 1.6+/-1.4; P=0.02) and the proportion of patients showing a > or = 1 g/dl increase in Hb was greater (0-3%, 27%; 4-9%, 57%; > or = 10%, 67%; P=0.02) in those with the largest %HRC pre-treatment.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Renal Medicine, St James's University Hospital, Leeds, UK.
authors.forename: C H
authors.initials: CH
authors.lastname: Jones
authors.forename: D
authors.initials: D
authors.lastname: Richardson
authors.forename: S
authors.initials: S
authors.lastname: Ayers
authors.forename: C G
authors.initials: CG
authors.lastname: Newstead
authors.forename: E J
authors.initials: EJ
authors.lastname: Will
authors.forename: A M
authors.initials: AM
authors.lastname: Davison
mesh_terms: D000740:Anemia / Q000188:drug therapy*; D004912:Erythrocytes / Q000737:chemistry*; D004920:Erythropoiesis; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007275:Injections, Intravenous; D007501:Iron / Q000008:administration & dosage*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D006454:Hemoglobins; D005293:Ferritins; D007501:Iron