title: Acceleration of iron utilization after intravenous iron administration during activated erythropoiesis in hemodialysis patients: a randomized study.
abstract: This study aimed to evaluate the effect of different timings of iron administration during erythropoiesis activated by continuous erythropoietin receptor activator (CERA) on reticulocyte iron uptake in hemodialysis patients. In total, 110 patients were randomized to receive 40 mg intravenous elemental iron doses at all three hemodialysis sessions in the first week (IW1 group: n = 57) or in the third week (IW3 group: n = 53) after CERA administration. Following CERA administration at day 0, reticulocyte count increased, peaking at day 7. At days 7 and 14, the observed changes in Ret-He were higher in the IW1 group than in the IW3 group. Increases in total reticulocyte hemoglobin at day 7 were higher in the IW1 group than in the IW3 group. In contrast, there was only tendency toward greater total reticulocyte hemoglobin after iron administration in the third week in the IW3 group. Intravenous iron supplementation in the first week of CERA administration increases reticulocyte iron uptake; however, iron supplementation in the third week does not. The findings indicate that iron should be intravenously administered to increase the efficacy of CERA within 1 week of CERA administration during highly active erythropoiesis.
authors.affiliation: Yokodai Central Clinic, Yokohama, Kanagawa, Japan; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine and School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kuji
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Toya
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fujikawa
authors.forename: Midori
authors.initials: M
authors.lastname: Kakimoto-Shino
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nishihara
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Shibata
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tamura
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Hirawa
authors.forename: Hidehisa
authors.initials: H
authors.lastname: Satta
authors.forename: Sei-ichi
authors.initials: S
authors.lastname: Kawata
authors.forename: Naoaki
authors.initials: N
authors.lastname: Kouguchi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D004920:Erythropoiesis / Q000187:drug effects*; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006403:Hematologic Tests; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000378:metabolism* / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000627:therapeutic use*; D006435:Renal Dialysis; D012156:Reticulocytes / Q000187:drug effects / Q000378:metabolism
chemical_list: C508420:continuous erythropoietin receptor activator; D004921:Erythropoietin; D011092:Polyethylene Glycols; D007501:Iron
keywords: Continuous erythropoietin receptor activator; Hemodialysis; Iron utilization; Renal anemia; Reticulocyte hemoglobin equivalent