Kooistra MP, van Es, A, Struyvenberg A, Marx JJM
Low iron absorption in erythropoietin-treated
haemodialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:543 1995
Studies from the pre-EPO era found that hemodialysis patients have no defect
in gastrointestinal iron absorption. This study revisits this issue in EPO
treated patients. Mucosal uptake and iron retention were studied using
radioisotopes of Fe and Cr, and a whole body counter. In HD patients who
appeared to be iron deficient, they found markedly reduced iron absorption
and retention compared to nonuremic iron deficient patients. In HD patients
with apparently normal iron stores, iron absorption was even more severely
depressed.
Comment: One of the most important anemia studies from this year's
ASN. This,
and other recent studies, leave the role of oral iron therapy in question.
Given the GI side-effects and patient non-compliance with oral iron, it is
disconcerting to note that the iron is probably not even being absorbed. It
is unclear why newer studies of iron absorption are finding significant
defects in HD patients, whereas studies in the pre-EPO era demonstrated
normal iron absorption.
(Fishbane)
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