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      Continuous Intravenous Sodium Ferric Gluconate Improves Efficacy in the Maintenance Phase of EPOrHu Administration in Hemodialysis Patients

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          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<sup>®</sup>) 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.

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          Author and article information

          Am J Nephrol
          American Journal of Nephrology
          S. Karger AG
          February 2002
          28 March 2002
          : 22
          : 1
          : 67-72
          aHemodialysis Unit and bLaboratory, Hospital General Juan Cardona, and cHematology Service, Hospital Arquitecto Marcide, Ferrol, Spain
          46676 Am J Nephrol 2002;22:67–72
          © 2002 S. Karger AG, Basel

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          Page count
          Figures: 1, Tables: 2, References: 28, Pages: 6
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          Clinical Study

          Cardiovascular Medicine, Nephrology

          Erythropoietin, Sodium ferric gluconate, Anemia, Hemodialysis


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