Iron Repletion in ESRD. Saleem Bharmal 2/9/10. Case. ESRD on maintenance hemodialysis who is noted to have a Hgb 10.6/TSAT 19%/Ferritin 617/iron 46/TIBC 238/on EPO 4000U/week What would you do in this situation in terms of ESA and iron?
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Fishbane S., J. Am. Soc. Nephrol. 1996 2654-2657
At 6 wk, hemoglobin increased significantly more (P 0.028) in the intravenous iron group (1.6 1.3 g/dl) than in the control group (1.1 1.4 g/dl).
Ferritin <800 or >800 ng/ml had no relationship to the magnitude or likelihood of responsiveness to intravenous iron relative to the control group.
After the run-in period, 19 patients randomized to the control group received ivID doses of 25 to 150 mg/wk for 6 months
serum ferritin to 658 ng/ml in the study group
Epoetin dose requirements for the study group decreased by the third month and remained 40% lower than for the control group