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Intra-dialytic oral iron therapy
G Dunea1, M A Swagel, U Bodiwala
1Cook Country Hospital, Hektoen Institute for Medical Research, WSKC Dialysis-Services, Chicago, IL.
The International Journal of Artificial Organs
|May 1, 1994
Summary
Oral iron therapy during dialysis is effective for many patients, improving hematocrit levels. This supervised intradialytic approach offers a safe alternative to intravenous iron, with good patient acceptance.
Area of Science:
- Nephrology
- Hematology
- Clinical Trials
Background:
- Anemia is common in hemodialysis patients.
- Oral iron therapy adherence can be a challenge.
- Intravenous iron dextran has known risks.
Purpose of the Study:
- To evaluate the efficacy and tolerability of oral iron therapy in hemodialysis patients.
- To assess the impact of supervised intradialytic oral iron on hematocrit levels.
- To determine if baseline ferritin or transferrin saturation predict response.
Main Methods:
- Observational studies conducted in a 140-patient inner-city dialysis unit.
- Patients received supervised oral ferrous sulfate (325 mg) tablets during dialysis.
- Hematocrit, serum ferritin, and transferrin saturation were monitored.
Main Results:
- High acceptance and tolerance of oral iron therapy (less than 10% refusal).
- Oral intradialytic iron achieved hematocrit ≥28% in 69% of patients and ≥30% in 42-52%.
- No correlation found between final hematocrit and serum ferritin or transferrin saturation; response was unpredictable by these markers.
Conclusions:
- Oral intradialytic iron therapy is a viable and well-tolerated option for hemodialysis patients.
- A significant proportion of patients can expect a good hematocrit response.
- This approach should be considered before resorting to intravenous iron due to safety concerns.