The Impact of Intravenous Iron Supplementation on Hematinic Parameters and Erythropoietin Requirements in Hemodialysis Patients

医学 促红细胞生成素 贫血 内科学 血液透析 血红蛋白 总铁结合能力 转铁蛋白饱和度 铁蔗糖 入射(几何) 胃肠病学 补血的 红细胞压积 缺铁 静脉注射铁 红细胞生成 铁蛋白 阿尔法 生物仿制药 艾博汀阿尔法 透析 肾脏疾病 缺铁性贫血 外科 加药 血清铁 物理 光学
作者
Sepideh Zununi Vahed,Elham Ahmadian,Seyedeh Mina Hejazian,Saba Esmaeili,Farahnoosh Farnood
出处
期刊:Advances in Therapy [Adis, Springer Healthcare]
卷期号:38 (8): 4413-4424
标识
DOI:10.1007/s12325-021-01826-3
摘要

Anemia is one of the most common complications of chronic kidney disease (CKD). As a result of the side effects of high doses of recombinant human erythropoietin (rhEPO) and the differences in the standard dose of the injectable iron, this study aimed to evaluate the effect of high and low intravenous iron supplementation on hematinic parameters and EPO requirements in patients under hemodialysis. This multicenter, randomized, double-blind clinical trial was conducted on 60 patients with CKD admitted to Sina and 29 Bahman hospitals in Tabriz, Iran in 2019–2020 to undergo hemodialysis. In the two studied groups, low (100 mg/week) and high (400 mg/week) doses of iron were administered and subjects were followed up for 6 months. The incidence of acute myocardial ischemia, stroke, and mortality during 6 months was recorded. The required rhEPO dosage (mg/week) to maintain hemoglobin levels between 10 and 12 g/dL in the high-dose iron group was significantly decreased during the follow-up period (52,129.03 ± 23,810 vs. 45,760 ± 20,978.71, P ≤ 0.028). Transferrin saturation (TSAT) index had a significant upward trend after iron injection and significant correlations with the serum levels of Fe (r ≥ 0.353, P ≤ 0.007), ferritin (r ≥ 0.315, P ≤ 0.016), and total iron binding capacity (r ≥ 0.219, P < 0.050) during the follow-up period in the studied groups. High-dose intravenous iron (400 mg/week) can reduce the mean dose of rhEPO requirements and increase the TSAT index over a period of 6 months in hemodialysis patients. High-dose IV iron administration can decrease cardiovascular events in hemodialysis patients with iron deficiency anemia.
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