Intravenous versus oral iron supplementation for preoperative stimulation of hemoglobin synthesis using recombinant human erythropoietin

To compare two modalities of iron supplementation for the preoperative stim ulation of erythropoiesis using recombinant human erythropoietin (rhEPO), 1 2 adults in normal hemoglobin and iron status due for elective surgery were randomized to rhEPO 200 U/kg body weight subcutaneously twice weekly combi ned with either iron sucrose 200 mg intravenously twice weekly or iron sulf ate 160 mg/day orally, for 3 weeks preoperatively, Efficacy was measured by the increases over baseline in hemoglobin, reticulocyte count, and ferriti n determined 3 days before surgery; preoperative reticulocyte count and fer ritin were significantly higher with intravenous iron, whereas the only sig nificant intragroup increases in hemoglobin between time points also occurr ed in this group, Intravenous iron significantly boosts the hematopoietic r esponse to rhEPO and prevents iatrogenic iron depletion in otherwise health y candidates for elective surgery.