Beneficial Effects of Maintenance Intravenous Iron Saccharate in Hemodialysis Patients

We evaluated in this study the effects of regular use of maintenance intravenous (IV) iron saccharate on the hematological parameters, iron stores, and erythropoietin (EPO) requirement in a group of stable hemodialysis (HD) patients. We maintained 34 stable HD patients (14 (41.2%) males) with a mean age of 43.1 ±16 years (range 17-69) and mean duration of HD of 39.3 ± 34.5 months on EPO. We also added 50-100 mg IV iron saccharate every week during a 6-month period from May-October, 1999. At entry, 18 (47.1%) patients required loading doses of IV iron saccharate. We compared the results at entry with those at six months. The mean hemoglobin increased significantly from 97 ± 10 to 117 ± 20 g/l, (p 0.0001), serum ferritin increased significantly from a mean of 160 ± 224 to 377 ± 216 ng/ml, (p 0.0001), transferrin saturation increased from 21 ±1.9 to 28 ± 8 %, (p= .0002), EPO dose decreased significantly from a mean weekly dose of 8800 ± 3200 to 5500 ± 3000 units (p=0.002). The cost saving analysis suggested an annual savings of 6448 Saudi Riyals (1719 US $) per patient attributable to reduction in the administered EPO dose. We conclude that IV iron saccharate use to replenish and maintain iron stores in stable EPO treated HD patients is safe and effective. It results in achieving target hemoglobin with significantly lower doses of EPO.