Effectiveness of oral and intravenous iron therapy in haemodialysis patients

Anaemia is a common and serious complication in patients with end-stage renal disease. Iron therapy is crucial in managing anaemia and maintenance of haemodialysis (HD) patients. This study investigated the efficacy of both oral and intravenous (i.v.) therapies, and the possible factors deleteriously affecting patient response to iron therapy. Forty patients on maintenance HD from a single institution were enrolled in this 6-month retrospective study. Group I (n = 20) received i.v. two ampoules of atofen® (ferric chloride hexahydrate 193.6 mg) per week for a total of 6 weeks (total dosage, 960 mg). Group II (n = 20) received oral ferrous sulphate S.C. Tab® (ferrous sulphate 324 mg) one pill three times daily (total dosage, 63,000 mg). Patients whose haematocrit (Hct) level increased at minimum 3% within the period were classified as responders. Iron i.v. ferric chloride (960 mg) was more effective than oral ferrous sulphate (63,000 mg) in correcting anaemia in HD patients with iron deficiency. In group I, serum triglyceride (TG) levels were significantly lower in patients responding to i.v. iron therapy than in patients with no response. In group II, serum high-sensitive C-reactive protein (hs-CRP) level was significantly lower in patients responding to oral iron therapy than patients with no response. The i.v. ferric chloride is more effective than oral ferrous sulphate in treating anaemia in HD patients with iron deficiency. Serum hs-CRP and TG levels may be parameters for predicting hyporesponsiveness to oral and i.v. iron therapies, respectively.