Clinical and Economical Significance of Consistent Replacementof Iron with Recombinant Human Erythropoietin in Treatment of Anaemia in Patients on Hemodialysis

Overview

Background.
Anaemia is a common phenomenon encountered in patients on hemodialysis. Although treatmentwith rHuEPO therapy is effective, it may fail even at high doses. As rHuEPO efficacy depends on the bioavailabilityof iron, we monitored the effect of consistent iron supplementation on hematocrit levels and rHuEPO dosage.Methods and Results. 24 patients of our outpatient dialysis centre were included in this study. The mean age was59 years. The age group over 60 included 14 patients. The mean duration of dialysis treatment was 23.8 months. Thepatients were followed for 6 months according to the NKF-DOQI (National Kidney Foudantion Dialysis OutcomesQuality Initiative) recommendations for the treatment of anaemia. Following values were examined monthly:hematocrit, transferin saturation (TSAT) and ferritin. Iron and rHuEPO dosage was adjusted accordingly. Genetictests for haemochromatosis were conducted in 4 patients with the highest value of TSAT and ferritin. TSAT increasedfrom a mean of 15.9 % to 35.9 % (p

Key words:
anemia, erythropoietin, iv iron therapy, hemodialysis