A randomized trial of once daily versus twice daily dosing of oral iron in CKD

Area of Science:

• Nephrology
• Hematology
• Pharmacology

Background:

• Chronic kidney disease (CKD) often involves iron deficiency anemia.
• Oral iron supplementation is a common treatment, but optimal dosing strategies in CKD require further investigation.
• Understanding the impact of different oral iron regimens on iron status and hematological parameters is crucial for effective patient management.

Purpose of the Study:

• To compare the effects of two oral iron dosing regimens on iron status and hematological parameters in patients with CKD stages G3-4.
• To evaluate changes in percentage transferrin saturation (%TSAT), serum ferritin, and other hematological markers over a 12-week period.

Main Methods:

• A single-center, open-label, randomized clinical trial involving 80 stable adult CKD patients.
• Participants received either 100 mg ferrous ascorbate once daily (OD) or 200 mg daily (BD) for 12 weeks.
• Primary outcome: change in %TSAT; Secondary outcomes: changes in iron status, hematological parameters, IL-6, and hepcidin.

Main Results:

• No significant difference in the change of %TSAT between the once-daily (OD) and twice-daily (BD) oral iron groups.
• The BD group showed a greater increase in serum ferritin compared to the OD group.
• Mean corpuscular hemoglobin concentration (MCHC) increased in the OD group, while it decreased in the BD group.

Conclusions:

• The study did not find a significant difference in %TSAT between different oral iron dosing regimens in CKD patients.
• Different dosing strategies may differentially affect serum ferritin and MCHC, warranting further exploration.
• Optimal oral iron dosing strategies for CKD patients require additional research to clarify their clinical impact.