Clinical review of the newer intravenous iron therapy options

The effectiveness of iron sucrose was recently evaluated in several small groups of hemodialysis patients in five regional dialysis units. Iron sucrose did not maintain hemoglobin levels above 11 g/dl and transferrin saturation above 25%. In addition, close to 50% of the patients experienced serum ferritin levels greater than 1100 ng/ml, suggesting iron overload. Consequently, iron therapy was withheld in these patients. Eventually, several patients experienced a decrease in ferritin levels to below 800 ng/ml and were administered iron therapy with sodium ferric gluconate instead of iron sucrose. These patients achieved hemoglobin levels greater than 11 g/dl, and serum ferritin levels remained within the target range after several months of treatment.