Weekly Low-Dose Iron May Reduce Overall Iron Use

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This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Smaller and more frequent IV iron dosing may result in a significant overall reduction in total iron use.
  • Patients had a significant decrease in average week dosing of ferric gluconate (83.9 mg in 2007 vs. 51 in 2008).

Smaller and more frequent IV iron dosing may result in a significant overall reduction in total iron use, according to a study presented at ASN's Renal Week 2009.

In a retrospective study conducted during two 12-month observation periods, Amit Sharma, MD, of the Boise Kidney and Hypertension Institute in Meridian, Idaho, and coworkers examined whether weekly IV iron therapy administered at serum ferritin levels up to 1,200 ng/mL improved anemia outcomes.

In 2007, iron sucrose was administered to hemodialysis patients who had a serum ferritin level between 100 and 800 ng/mL. It was given either as a 1 g bolus over 10 treatments or with a variable regular low-dose strategy of 200 to 400 mg per month. Iron sucrose was withheld if patients' serum ferritin levels exceeded 800 mL.

In 2008, iron sucrose was switched to sodium ferric gluconate. Regular low-dose ferric gluconate (62.5 mg weekly) was administered to patients who had a serum ferritin level between 200 and 1,200 ng/mL. The primary end point was the change in the average weekly dose of IV iron.

The study focused on 15 patients who had continuous data for 24 months, enabling the subjects to serve as their own controls. In the 2008 analysis, the patients had a significant decrease in average week dosing of ferric gluconate (83.9 mg in 2007 vs. 51 in 2008). The requirement for erythropoiesis-stimulating agents did not change significantly. Hemoglobin levels, transferrin saturation, and serum ferritin values were maintained within target levels.

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