ITDI is the preferred treatment for iron supplementation in rHuEpo-treated anemic PD patients

In recombinant human erythropoietin (rHuEpo)-treated anemic peritoneal dialysis (PD) patients, oral iron therapy, despite its limited efficacy, remains an accepted and convenient method of iron supplementation. In this study, we compared infusion of total dose iron (ITDI) to oral iron for the treatment of anemia in PD patients. Thirteen patients with serum transferrin saturation (TSAT) < 25% received ITDI and 11 patients with TSAT between 25% to 35% received oral iron. Doses of rHuEpo were adjusted monthly to maintain target hematocrit at 35%. Both groups had similar baseline mean hematocrits (31.0 +/- 0.9% vs. 33.0 +/- 1.0%), and comparable mean baseline weekly rHuEpo dose (7886 +/- 1449 units/week vs. 6370 +/- 1553 units/week). At the end of the 6-month study, the ITDI group had a 16% improvement in mean hematocrit compared to baseline. The final mean dose of weekly rHuEpo was also reduced by 59% in the ITDI group. During the same period, compared to baseline, the oral group had a 4.8% fall in mean hematocrit despite 51% higher requirement of rHuEpo doses. There was no adverse reaction to intravenous iron. We conclude that ITDI is the preferred treatment for iron supplementation in rHuEpo-treated anemic PD patients.