Document Detail


Functional iron deficiency in hemodialysis patients with high ferritin.
MedLine Citation:
PMID:  17403177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although functional iron deficiency (FID) may be present in hemodialysis (HD) patients with high serum ferritin levels (>800 ng/mL), current protocols often preclude the use of intravenous (IV) iron in these patients. However, it has not been demonstrated that iron supplementation during erythropoietin therapy is ineffective or unsafe in increasing hemoglobin (Hb) levels in patients with high serum ferritin. This report describes the hematologic efficacy and safety of ferric gluconate (FG) therapy in patients with serum ferritin >800 ng/mL. A retrospective analysis was performed on HD patients at a single California dialysis center from January 1 to December 31, 2003. Patients classified as having high ferritin levels (serum ferritin >800 ng/mL on at least 66% of routine monthly measurements and transferrin saturation [TSAT] <25% on at least 1 occasion) were stratified as follows: patients in Group I were suspected of having FID and received FG > or =250 mg IV over a 3-month period when Hb was <11 g/dL, and patients in Group II were thought not to have FID and received <250 mg FG over a 3-month period. Both groups received standard recombinant human erythropoietin therapy as per the unit's protocol. Of 496 patients, 95 exhibited high ferritin and of these, 39 patients had sufficient data for analysis. Group I patients (n=14) showed a significant increase in Hb levels compared with Group II (n=25). There was no increase in ferritin levels in response to iron administration. No significant differences in hospitalizations or infections were observed between groups. Hemodialysis patients with high ferritin levels may have FID, and IV iron therapy safely improves FID in some patients. A larger randomized trial examining the optimal management of iron administration in HD patients with high ferritin levels is warranted.
Authors:
Robert C Kopelman; Lorelei Smith; Leonard Peoples; Ronna Biesecker; Adel R Rizkala
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hemodialysis international. International Symposium on Home Hemodialysis     Volume:  11     ISSN:  1492-7535     ISO Abbreviation:  Hemodial Int     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-03     Completed Date:  2007-06-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101093910     Medline TA:  Hemodial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  238-46     Citation Subset:  IM    
Affiliation:
Bakersfield Dialysis Center, Bakersfield, California 93301, USA. rckopelman@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Case-Control Studies
Drug Resistance
Erythropoietin, Recombinant / administration & dosage
Female
Ferric Compounds / administration & dosage
Ferritins / blood*
Hemoglobins / analysis
Hospitalization
Humans
Infection
Iron / deficiency*
Male
Middle Aged
Renal Dialysis / adverse effects*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Erythropoietin, Recombinant; 0/Ferric Compounds; 0/Hemoglobins; 7439-89-6/Iron; 88088-23-7/ferric gluconate; 9007-73-2/Ferritins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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