Clinical Study

Continuous Intravenous Sodium Ferric Gluconate Improves Efficacy in the Maintenance Phase of EPOrHu Administration in Hemodialysis Patients
Luis Bolaños^a, Pedro Castro^b, Teresa G. Falcón^a, Ricardo Mouzo^a, José Manuel Varela<sup>c

a</sup>Hemodialysis Unit and
^bLaboratory, Hospital General Juan Cardona, and
^cHematology Service, Hospital Arquitecto Marcide, Ferrol, Spain

Address of Corresponding Author

Am J Nephrol 2002;22:67-72 (DOI: 10.1159/000046676)

  Key Words

• Hemodialysis
• Sodium ferric gluconate
• Erythropoietin
• Anemia

  Abstract

Although intravenous iron has proved to optimize the efficacy of EPOrHu in hemodialysis patients, hitherto no consensus exists with respect to the best regimen of intravenous iron administration. We started a prospective randomized study in 26 patients undergoing chronic hemodialysis who had adequate iron metabolism indices (serum ferritin >100 µg/l; %TSAT >20%; %HypoE <10% and CHr >26 pg) and were in the maintenance phase of EPOrHu administration (target hemoglobin obtained >10 g/dl). All patients were receiving sodium ferric gluconate (Ferrlecit^®) intermittently prior to the study and after a 1-month wash-out period where iron was not administered patients were randomized to receive the same previous dose of intravenous iron either in a continuous (6.25-21.3 mg in every hemodialysis session) or an intermittent regimen (62.5 mg every 1-4 weeks, not modifying the previous schedule of administration). At 16 weeks, the continuous group showed a significant increment in serum Hb (11.83 ± 1.12 g/dl) with respect to baseline (10.96 ± 1.31 g/dl) (p < 0.05), whereas no differences were obtained in intermittent group (baseline: 11.16 ± 1.03 g/dl; 16 weeks: 11.14 ± 0.90 g/dl, NS). In contrast with the intermittent group, serum ferritin increased significantly in the continuous group (16 weeks: 508 ± 157 µg/l; baseline: 368 ± 56 µg/l; p < 0.05), whereas %TSAT and CHr did not modified during the study in both groups. %HypoE increased significantly with respect to baseline values in the continuous group (p < 0.05) and close to significantly different in the intermittent group (p = 0.06). Our study suggests that hemodialysis patients in the maintenance phase of EPOrHu administration would obtain further benefit in terms of serum hemoglobin level with a continuous intravenous serum ferric gluconate regimen, at least in the short term.

Copyright © 2002 S. Karger AG, Basel

  Author Contacts

Luis Bolaños Cea
Avda Ejército, nº 10, 18-B
E-15006 La Coruña (Spain)
Tel. +34 981 285605, E-Mail lbolanosc@senefro.org

  Article Information

Received: Received: May 7, 2001
Accepted: December 18, 2001
Number of Print Pages : 6
Number of Figures : 1, Number of Tables : 2, Number of References : 28