Infusing a monthly maintenance intravenous (IV) dose of 100 mg iron sucrose may be a practical approach to treating anemia in patients on peritoneal dialysis (PD), investigators reported in International Urology and Nephrology.

In a pilot study, Efstathios Mitsopoulos, MD, of General Hospital of Thessaloniki Papageorgiou, in Greece, and colleagues assigned 15 patients on PD patients to receive 200 mg IV iron sucrose as a loading dose followed by monthly doses of 100 mg for 5 months. No one received other iron formulations or phosphate binders containing iron.

By 3 months after the last infusion, mean hemoglobin (Hb) and ferritin had increased significantly from 10.0 to 10.9 mg/dL and from 143 to 260 ng/mL, respectively. Transferrin saturation rose from 26.2% to 33.1%, but the increase was not significant.

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Five patients experienced a 27% reduction in erythropoietin dose during the 6 months of iron administration. Erythropoietin was discontinued in 1 patients. During the 3 months following the final iron infusion, the erythropoietin dose was increased to previous levels in 3 patient.

No side effects were reported.

“In conclusion, in an effort to administer the minimum monthly IV iron dose that could improve hemoglobin levels and at the same time enhance response to EPO,” the authors concluded, “we demonstrated for the first time that a once monthly IV administration of 100 mg iron sucrose appears to be safe in the short term and effective in treating anemia in PD outpatients.”

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Mitsopoulos E, Lysitska A, Pateinakis P, et al. Efficacy and safety of a low monthly dose of intravenous iron sucrose in peritoneal dialysis patients. Intl Urol Nephrol. doi: 10.1007/s11255-019-02362-4