Jonnalagadda V, Bloom E, Raja R
Importance of iron saturation for erythropoietin
responsiveness in chronic peritoneal dialysis
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S74 1997
The best means of measuring iron stores is controversial. Most of the
recent work has focused on HD patients. The concepts that have emerged
with HD patients are, that absolute Fe deficiency exists with iron
saturation < 20%, but patients with saturations between 20 and 30% often
improve their Hct if given iron dextran. The data in PD patients is more
sparse, although there is no reason a priori why it should be any
different.
In this study the question was addressed somewhat indirectly in 38 PD
patients. One looked at the EPO dose, and then divided the patients into
low, medium, and high dose EPO recipients, with mean weekly EPO doses in
the 3 groups being 37, 71, and 141 U/kg, respectively. Not surprisingly,
iron saturation averaged 30% in patients in the low EPO dose group (Hct
35%), 28% in patients in the moderate EPO dose group, and 22% in patients
in the high dose EPO group. Serum ferritin levels were similar in the 3
groups, averaging 260-312 ng/ml.
Comment: The data suggest that iron saturation is a more important
predictor of iron deficiency than ferritin, and that levels up to 30% may
continue to improve EPO requirements. The study was small and the methods
were indirect, however.
(John T. Daugirdas, M.D., University of Illinois at Chicago)
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17th Annual CAPD Conference
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