title: Iron absorption after single pharmacological oral iron loading test in patients on chronic peritoneal dialysis and in healthy volunteers.
abstract: OBJECTIVE
  Oral iron is poorly absorbed in chronic dialysis patients. We tested the hypothesis that a superpharmacologic dose of iron sulfate (260 mg elemental iron) administered on an empty stomach results in significant iron absorption in these patients.
  
  
  METHODS
  A prospective open controlled trial.
  
  
  METHODS
  Outpatient department of a university hospital.
  
  
  METHODS
  Nine stable chronic peritoneal dialysis (PD) patients and seven normal control subjects.
  
  
  METHODS
  All subjects ingested a single dose of 4 tablets of iron sulfate (260 mg elemental iron total) in the morning while fasting.
  
  
  METHODS
  Serum iron concentrations at baseline, and at 2 and 4 hours after the oral dose were compared between the two groups.
  
  
  RESULTS
  The control group showed a significant rise in mean [standard error (SE)] serum iron concentration, from a baseline value of 76.5 +/- 7 microg/dL to 191 +/- 10.5 microg/dL at 2 hours and to 190 +/- 24 microg/dL at 4 hours. This result represents a percentage rise of 164% +/- 32% at 2 hours and 152% +/- 28.5% at 4 hours. In the PD patients, a significant rise in serum iron concentration was also seen, from a baseline value of 64 +/- 8 microg/dL to 130 +/- 3 microg/dL at 2 hours and 111 +/- 18 microg/dL at 4 hours. This result represents a percentage rise of 105% = 29% at 2 hours and 77% +/- 23.5% at 4 hours. However, the absolute change in serum iron concentration in PD patients at 2 and 4 hours was approximately equal to 50% of the change in control subjects at those time points. None of the PD patients experienced gastrointestinal side effects; 4 control subjects experienced mild side effects.
  
  
  CONCLUSIONS
  Despite impaired oral iron absorption in chronic dialysis patients, a large pharmacologic dose given orally can result in significant iron absorption and may prove to be a more efficient means of oral iron supplementation therapy in these patients.
authors.affiliation: Division of Nephrology, Saint Louis University School of Medicine, St. Louis, Missouri 63110, USA. bastanib@slu.edu
authors.forename: B
authors.initials: B
authors.lastname: Bastani
authors.forename: S
authors.initials: S
authors.lastname: Islam
authors.forename: N
authors.initials: N
authors.lastname: Boroujerdi
mesh_terms: D000042:Absorption; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000493:pharmacokinetics*; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D011446:Prospective Studies
chemical_list: D007501:Iron