the effect of intravenous and oral iron administration on responsiveness to synthetic erythropoietin in treatment of hemodialysis patients' anemia

the effect of intravenous and oral iron administration on responsiveness to synthetic erythropoietin in treatment of hemodialysis patients&apos; anemia     shariati ar [1] , asayesh h [2] , mojerloo m [3] , karimi taleghani h [4]     received: 10june, 2011 accepted: august 28, 2011     abstract   background & aims : 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&apos;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&apos; anemia.   keyword : hemodialysis patients, indrovenous iron, oral iron, erythropoietin, anemia     address : nursing & midwifery faculty, golestan university of medical sciences, gorgan, iran   tel : +98 9111702997   email : [email protected]   [1] instructor of nursing, nursing & midwifery faculty, golestan university of medical sciences, gorgan, iran (corresponding author)  [2] instructor of nursing, paramedical faculty, qom university of medical sciences, qom, iran   [3] assistant professor, medicine faculty, golestan university of medical sciences, gorgan, iran  [4] internal medicine physician