IV Iron, Erythropoietin Equally Effective for Anemia in HD Patients

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Intravenous iron and erythropoietin produced a similar hemoglobin response among hemodialysis patients with moderate anemia.
Intravenous iron and erythropoietin produced a similar hemoglobin response among hemodialysis patients with moderate anemia.
The following article is part of conference coverage from Kidney Week 2017 in New Orleans hosted by the American Society of Nephrology. Renal & Urology News staff will be reporting live on medical studies conducted by nephrologists and other specialists who are tops in their field in acute kidney injury, chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from Kidney Week 2017.

NEW ORLEANS—Intravenous (IV) iron and erythropoietin are equally effective for treating anemia in most hemodialysis patients, British researchers concluded in a poster presentation at the American Society of Nephrology's Kidney Week 2017 meeting.

In a randomized controlled trial, Damien Ashby, PhD, and colleagues at Imperial College Renal and Transplant Centre in London studied 194 stable HD patients who became moderately anemic (hemoglobin level 90-104 g/L). They randomly assigned patients to treatment with either IV iron (1 g divided over 5 consecutive sessions [IVFE group]) or increased erythropoietin (starting 3000 units per week or median increase of 50% [EPO group]). They followed up patients for as long as 18 months.

Dr Ashby's team observed a positive hemoglobin response (an increase of at least 5 g/L by 2 months) in 54 (71.1%) of 76 IVFE patients and 62 (73.8%) of 84 EPO patients, a between-group difference that was not statistically significant.

In the IVFE group, compared with non-responders, lower hepcidin levels and lower mean cell volume predicted a positive hemoglobin response. In the EPO-treated patients, only low C-reactive protein predicted a positive hemoglobin response.

Ferritin levels did not predict hemoglobin response in either group.

Visit Renal & Urology News' conference section for continuous coverage from Kidney Week 2017.

Reference

Hildebrand S, Duncan ND, Tam FWK, Ashby D. Randomised controlled trial of intravenous iron versus increased erythropoietin in haemodialysis anaemia. Presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31 to Nov. 5). Abstract SA-PO824.

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