Fishbane S, Frei GL, Maesaka J
Reduction in recombinant human erythropoietin doses by the use of chronic intravenous iron supplementation

Am J Kidney Dis (Jul) 26:41-46 1995

Fifty two patients taking EPO and oral iron, without laboratory evidence of iron deficiency (mean serum ferritin of about 185 ng/ml and mean transferrin saturation of 22%, baseline Hct 32%) were randomized to receive either oral or IV iron. Oral iron was the sulfate in 21 patients and polysaccharide in 11. The IV iron dose (Infed) was 100 mg twice weekly IV push over 2 min. IV iron was given to the oral iron group if TSAT < 12.5% or if ferritin < 50. After 4 months, in the routine IV iron group, Hct was higher (34.4 vs. 31.8), and the EPO dose lower (4,000 U/tx vs. 7,600 U/tx), and the ferritin was higher (750 vs. 160). TSAT was 75% vs. 20%. Four months after stopping routine Infed, ferritin had decreased to 180 and TSAT to 20%. A test dose of 25 mg Infed was used prior to each IV iron dose, and no anaphylactic reactions to Infed were observed. The results suggest that some form of semi-routine IV iron supplementation is useful in dialysis patients, although it appears that the perhaps the dose used may have been too high, and that the dose needs to be tailored to the individual patient. (Daugirdas)

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CRF by problem area : Anemia/Erythropoietin/Iron