title: Iron status and benefit of the use of parenteral iron therapy in pre-dialysis Chronic Kidney disease patients.
abstract: OBJECTIVE
  Anaemia is a major cardiovascular risk factor in chronic kidney disease (CKD). Treatment and correction of anaemia leads to improvement of cardiovascular status and quality of life of patients with CKD. This interventional open labeled randomised controlled study comparing the effect of intravenous and oral iron therapy in improving red cell indices and iron status in anaemic pre-dialysis Chronic Kidney Disease was carried out to determine iron status in anaemic pre-dialysis CKD patients to assess the benefit of parenteral iron supplementation as against empirical oral iron in CKD patients with iron deficiency.
  
  
  METHODS
  Sixty consecutive pre-dialysis chronic kidney disease patients attending the renal clinic over a six month period were screened. Forty- one subjects (68.3%) were found to be anaemic and were subsequently studied.
  
  
  RESULTS
  The ages of the patients ranged between 19 and 71 years with a mean age of 39 years. The mean serum creatinine and mean creatinine clearance were 201.80 (70.25)?mol/L and 37.90 (± 12.17)ml/minute respectively. The haematocrit concentration was found to correlate inversely with the level of serum creatinine and 56.1% of the anaemic patients had iron deficiency. The mean PCV rise in the intravenous iron group was 2.42 (± 1.98)% and this was statistically significant (p=0.002) while the mean PCV difference was 0.909 (± 0.94)% in the oral iron group. Intravenously administered iron alone permitted anaemia correction in about one-third of these patients without any life threatening adverse drug event.
  
  
  CONCLUSIONS
  Anaemia is very common in the pre-dialysis CKD population and the prevalence of iron deficiency is high. Intravenous iron supplementation is an effective and safe treatment for the anaemia in the pre-dialysis CKD patients. Response to oral iron was poor.
authors.affiliation: Department of Medicine, Obafemi Awolowo University Ile-Ife, Nigeria, P.M.B 5538 Ile-Ife, Osun State, Nigeria. fatiu3@yahoo.com
authors.forename: F A
authors.initials: FA
authors.lastname: Arogundade
authors.forename: F O
authors.initials: FO
authors.lastname: Soyinka
authors.forename: A A
authors.initials: AA
authors.lastname: Sanusi
authors.forename: O E
authors.initials: OE
authors.lastname: Ojo
authors.forename: A
authors.initials: A
authors.lastname: Akinsola
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000740:Anemia / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005296:Ferrous Compounds / Q000008:administration & dosage*; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D007505:Iron-Dextran Complex / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D005296:Ferrous Compounds; D006397:Hematinics; D007505:Iron-Dextran Complex; C011819:ferrous gluconate