THE EFFECT OF INTRAVENOUS AND ORAL IRON ADMINISTRATION ON RESPONSIVENESS TO SYNTHETIC ERYTHROPOIETIN IN TREATMENT OF HEMODIALYSIS PATIENTS' ANEMIA

Inadequate production of erythropoietin is the main cause of anemia in chronic
kidney disease (CKD) patients and iron deficiency is the common cause of low response to synthetic
erythropoietin in treatment of hemodialysis patients with anemia. This study was aimed to compare
the effect of intravenous and oral iron administration on responsiveness to synthetic erythropoietin in
increasing hemodialysis patients’ hemoglobin.
Materials & Methods: In this controlled single blind clinical trial, 42 hemodialysis patients with
hemoglobin concentrations less than 10 mg/dl after seven weeks of treatment with 2000 unit's
subcutaneous erythropoietin (three times a week after the end of each dialysis session) entered the
study. After random allocation the patients were divided into two groups: oral iron supplementation
(50 mg tablet as daily) was given to one and intravenous iron (100 mg three times a week after each
dialysis session) for the other group. Finally, the dependent variables were measured again. The data
were analyzed by t-test and paired t-test using SPSS software.
Results: The mean of hemoglobin and iron saturation was significantly increased in both groups
(P<0.05). However, the average difference was statistically significant in intravenous iron group
before and after injection compared with oral iron group (P<0.05). Ferritin level was not significantly
different before and after iron supplement taking in oral iron group (P>0.05) whereas it was significant
in intravenous iron group (P<0.05).
Conclusion: The current study finding indicated intravenous iron with erythropoietin leads to better
response in treatment of hemodialysis patients' anemia