INTRAVENOUS FERRIC SACCHARATE AS AN IRON SUPPLEMENT IN DIALYSIS PATIENTS

In the present prospective study we examined the long-term effect of i ntravenous supplementation with ferric saccharate (IV Fe) in the treat ment of the anemia of chronic dialysis patients. All patients, 64 on c hronic hemodialysis (HD) and 9 on chronic ambulatory peritoneal dialys is (CAPD), were treated intravenously with this preparation in a dose of 100 mg elemental iron twice monthly. There were five groups. Group 1: 41 HD patients who were receiving erythropoietin (EPO) for at least 6 months prior to the addition of IV Fe. In this group, when IV Fe wa s given over 6 months, the hematocrit (Hct) increased from a mean of 2 8.7 to 33.7%. Over the next 6 months, the EPO dose was gradually reduc ed by a mean of 61.1%, but the mean Hct remained unchanged. Group 2: 1 1 HD patients who started IV EPO simultaneously with the IV Fe. In thi s group, over 6 months, the mean Hct increased from 28.1. to 34.1. Ove r the next 6 months, the EPO dose was gradually reduced by 75.7%, but the mean Hct remained unchanged. Group 3: 12 HD patients who received IV Fe alone for 12 months. The mean Hct increased from 30.5 to 37.9%. Group 4: 4 CAPD patients who had been receiving subcutaneous EPO for a t least 6 months prior to IV Fe therapy. Over the subsequent 6 months of IV Fe, the mean Hct increased from 28.4 to 33.3%. Group 5: 5 CAPD p atients not on EPO who received IV Fe for 6 months. The mean Hct incre ased from 27.7 to 35.6%. No adverse effects were seen in any patients throughout the study. In conclusion, adequate Fe supplementation may a llow the target Hct of about 33% to be reached without, or with only v ery low doses of EPO. IV Fe as ferric saccharate is a new and safe for m of parenteral iron therapy of the anemia of chronic dialysis patient s.