Iron Repletion Does Not Lower Platelet Counts

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LAS VEGAS—Correction of iron deficiency does not significantly lower platelet counts in patients with chronic kidney disease (CKD), regardless of molecular weight or dose used, according to investigators.

Platelet counts have been reported to vary directly with the severity of iron deficiency in hemodialysis (HD) patients, the researchers noted. In addition, platelet counts were decreased after IV iron administration in the recent DRIVE study. As a result, some researchers have hypothesized that iron deficiency may produce a relative thrombocytosis that may contribute to thrombotic events observed in clinical trials of erythropoiesis-stimulating agents in CKD patients.

Steven Turley, MD, of the Veterans Affairs Medical Center in Shreveport, La., and colleagues analyzed chart data from 153 patients who received a total of 250 doses of iron dextran total dose infusion (TDI). TDI diluted in normal saline was administered intravenously, given as a bolus over four to six hours.

Hemoglobin levels and iron stores improved significantly after TDI. Platelet counts declined insignificantly from 255 before TDI to 244 after TDI, according to data presented at the National Kidney Foundation's Spring Clinical Meetings. The decrease remained insignificant when data were stratified by molecular weight of iron dextran used (low vs. high), as well as by dose administered (less than 1,000 vs. more than 1,000 mg).

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