title: Very low doses of direct intravenous iron in each session as maintenance therapy in hemodialysis patients.
abstract: BACKGROUND
  Intravenous (IV) iron supplementation is widely used in hemodialysis (HD) patients to treat their periodic losses. However, the ideal dose and frequency is unknown. The goal of the study is to see if a 20 mg dose of iron IV at the end of each session of HD as iron maintenance is better than the iron prior therapy. We analyze the erythropoiesis activity (EA) and functional iron (FI) after four weeks of treatment.
  
  
  METHODS
  In 36 patients, we measure reticulocyte count and content of hemoglobin reticulocyte (CHr) as EA and FI markers, respectively, before and after the treatment. Before the study, 23 patients received another different therapy with IV iron as maintenance therapy.
  
  
  RESULTS
  Reticulocyte count: 49.7 ± 23.8 × 10(3) before and 47.2 ± 17.2 × 10(3) after the treatment (p= 0.51). The CHr: 34.8 ± 3.7 pg and 34.4 ± 3.5 pg, respectively, (p= 0.35), showing an excellent correlation with the other FI markers (serum iron r = 0.6; p = 0.001; saturation transferrin r = 0.49; p = 0.004); that is not shown with the serum ferritin (r = 0.23; p = 0.192) or the hepcidin levels (r = 0.22; p = 0.251). There was not a correlation between the C-Reactive Protein, reticulocyte count, and CHr. The 13 patients who did not receive the iron prior to the study showed high FI levels, but not an increased of the serum ferritin or the serum hepcidin levels.
  
  
  CONCLUSIONS
  The administration of a small quantity of iron at the end of every HD session keeps the EA and the FI levels and allows reducing the iron overload administered and/or decreasing the iron stores markers in some patients.
authors.affiliation: a Department of Internal Medicine, Division of Nephrology , San Pedro De Alcántara Hospital , Cáceres , Spain ;
authors.forename: Javier
authors.initials: J
authors.lastname: Deira
authors.affiliation: a Department of Internal Medicine, Division of Nephrology , San Pedro De Alcántara Hospital , Cáceres , Spain ;
authors.forename: Silvia
authors.initials: S
authors.lastname: González-Sanchidrián
authors.affiliation: a Department of Internal Medicine, Division of Nephrology , San Pedro De Alcántara Hospital , Cáceres , Spain ;
authors.forename: Santiago
authors.initials: S
authors.lastname: Polanco
authors.affiliation: a Department of Internal Medicine, Division of Nephrology , San Pedro De Alcántara Hospital , Cáceres , Spain ;
authors.forename: Clarencio
authors.initials: C
authors.lastname: Cebrián
authors.affiliation: a Department of Internal Medicine, Division of Nephrology , San Pedro De Alcántara Hospital , Cáceres , Spain ;
authors.forename: María
authors.initials: M
authors.lastname: Jiménez
authors.affiliation: a Department of Internal Medicine, Division of Nephrology , San Pedro De Alcántara Hospital , Cáceres , Spain ;
authors.forename: Jesús
authors.initials: J
authors.lastname: Marín
authors.affiliation: a Department of Internal Medicine, Division of Nephrology , San Pedro De Alcántara Hospital , Cáceres , Spain ;
authors.forename: Juan-Ramón
authors.initials: JR
authors.lastname: Gómez-Martino
authors.affiliation: b Service of Clinical Laboratory, Division of Immunology , San Pedro De Alcántara Hospital , Cáceres , Spain ;
authors.forename: Luis
authors.initials: L
authors.lastname: Fernández-Pereira
authors.affiliation: c Service of Nephrology, Salamanca University Hospital , Salamanca , Spain.
authors.forename: José
authors.initials: J
authors.lastname: Tabernero
mesh_terms: D061605:Administration, Intravenous; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D004920:Erythropoiesis / Q000187:drug effects; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D000077605:Ferric Oxide, Saccharated; D005293:Ferritins / Q000097:blood; D005937:Glucaric Acid / Q000008:administration & dosage*; D006397:Hematinics / Q000008:administration & dosage*; D006454:Hemoglobins / Q000032:analysis; D064451:Hepcidins / Q000097:blood; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D060046:Maintenance Chemotherapy / Q000379:methods*; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects*; D017701:Reticulocyte Count; D012156:Reticulocytes / Q000378:metabolism; D014168:Transferrin / Q000032:analysis
chemical_list: D015415:Biomarkers; D005290:Ferric Compounds; D006397:Hematinics; D006454:Hemoglobins; D064451:Hepcidins; D014168:Transferrin; D002097:C-Reactive Protein; D005293:Ferritins; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid
keywords: Anemia; erythropoietic activity; hemodialysis; intravenous iron; reticulocyte count