PERCENTAGE HYPOCHROMIC RED-CELLS AND THE RESPONSE TO INTRAVENOUS IRONTHERAPY IN ANEMIC HEMODIALYSIS-PATIENTS

Introduction. Iron deficiency is commonly encountered in haemodialysis (HD) patients and may be overcome by i.v. iron therapy. We have exami ned the percentage hypochromic red cells (%HRC) for predicting respons e to i.v. iron in subjects with a low serum ferritin. Methods. Prospec tive study of i.v. iron saccharate (trivalent iron 200 mg/week for 8 w eeks) in anaemic (Hb < 10 g/dl) HD patients with serum ferritin < 100 mu g/l despite oral iron therapy. Response to i.v. iron was assessed b y comparing Hb at 0 and 8 weeks according to %HRC at baseline (0-3%, 4 -9%, greater than or equal to 10%). Results are mean +/- 1 SD. Results . For all subjects (n = 82), Hb and ferritin increased between 0 and 8 weeks (8.9 +/- 1.0 to 10.1 +/- 1.4, P < 0.0001; 55 +/- 24 to 288 +/- 126, P < 0.0001). Patients were stratified into three groups according to %HRC at baseline (0-3%, 4-9%, greater than or equal to 10%). Hb in creased significantly in all three groups. The mean increase in Hb was greater (0-3%, 0.6 +/- 1.2, 4-9%, 1.2 +/- 1.0; greater than or equal to 10%, 1.6 +/- 1.4; P = 0.02) and the proportion of patients showing a greater than or equal to 1 g/dl increase in Hb was greater (0-3%, 27 %; 4-9%, 57%; greater than or equal to 10%, 67%; P = 0.02) in those wi th the largest %HRC pre-treatment. Conclusion. Intravenous iron therap y is effective in improving Hb in anaemic HD patients with a low ferri tin. However, the magnitude of this response and the proportion of pat ients responding is related to the percentage hypochromic red cells pr ior to treatment.