Intravenous Iron Administration during the Maintenance Period in Erythropoietin-treated Hemodialysis Patients: A Simple and Effective Method
Suwattanachai Nurnuansuwan MD*, Asada Leelahavanichkul MD**, Pongsak Pansin BSc**, Somchai Eiam-Ong MD**
Affiliation : * Medical Department, Fort Suranaree Hospital, Nakorn Rasima ** Department of Medicine, Faculty of Medicine, Chulalongkorn University
Objectives : To determine the interval of intravenous iron administration during maintenance iron therapy in
erythropoietin-treated hemodialysis patients.
Materials and Methods : The method of maintenance intravenous iron therapy has been studied in 20 stable
erythropoietin-treated hemodialysis patients who have iron deficiency anemia diagnosed by transferin
saturation (TSAT) below 20%.
Results : After receiving 1,000 mg of intravenous iron as the first loading dose, the TSAT was increased from
16.4 + 0.5 to 29.3 + 2.6% (p < 0.05). After 155.6 + 7.3 days, such values was reduced to 16.3 + 1.4% (p <
0.05). The second loading dose was administered and could raise the TSAT to 33.7 + 3.9% (p < 0.05). The
patients, then, received 100 mg of intravenous iron for every 15.6 + 2.9 days, one-tenth of the duration
between the two loading doses. The values of TSAT at 1,2,3,4,5 and 6 months after the second loading dose
were 38.5 + 2.4, 37.1 + 0.2, 34.2 + 3.6, 34.1 + 3.3, 35.3 + 4.1, and 36.5 + 3.1% (NS).
Conclusion : As such, in erythropoietin-treated hemodialysis patients, after loading with 1,000 mg, prescrip-
tion of 100 mg of intravenous iron for every 2 weeks could maintain the TSAT levels above 20%.
Keywords : Hemodialysis, Iron deficiency anemia, Intravenous iron therapy, TSAT
