IV and oral iron increase hemoglobin similarly in non-dialysis CKD patients, but IV iron may result in more rapid repletion of iron stores.
Researchers studied 75 anemic, iron-deficient patients with stage 3 or higher CKD. Thirty-six patients received a sodium ferric gluconate complex (IV iron) 250 mg weekly for four weeks and 39 received ferrous sulfate (oral iron) 325 mg three times daily for 42 days. The change from baseline in hemoglobin concentration was 0.4 g/dL in the IV iron group and 0.2 g/L in the oral iron group, a nonsignificant difference between the study arms, according to a report in the American Journal of Nephrology (2006;26:445-454).
Compared with oral iron, IV iron achieved greater improvements in ferritin (232 vs. 55.9 ng/mL) and transferrin saturation (8.3% vs. 2.9%). It was also associated with improvements in quality-of-life scores.