Maintenance of elevated versus physiological iron indices in non-anaemic patients with chronic kidney disease: a randomized controlled trial

L.P. Mcmahon, A.B. Kent, P.G. Kerr, H. Healy, Ashley Irish, B. Cooper, A. Kark, S.D. Roger

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    Abstract

    An optimal haemoglobin (Hb) response to erythropoietin requires elevated iron indices in dialysis patients; however, it is unknown if the same applies in chronic kidney disease (CKD).Methods. One hundred patients [CKD Stages 3–5, Hb ≥ 110 g/L, iron replete, erythropoietin-stimulating agent (ESA)-naive, 47% diabetic, median age 69.5 years] were block-randomized in an open-label study to receive up to 200 mg intravenous iron sucrose (Group A, n = 52) bimonthly or oral iron sulphate (Group B) to maintain raised and normal iron indices (respectively) over 12 months. The primary endpoint was the change in Hb concentration at 12 months or at termination after at least 6 months of treatment.Results. Eighty-five patients reached the primary endpoint (43, Group A; 42, Group B). Initial Hb was 119 ± 7 vs 116 ± 12 g/L (mean ± standard deviation); ferritin 122 (71–176), median (inter-quartile range), vs 90 µg/L (58–150); transferrin saturation (TSat) 22 (18–26) vs 21% (15–24); and creatinine 240 (195–313) vs 230 µmol/L (184–352). Ferritin and TSat differed by month 2 [157 (103–220) vs 96 µg/L (73–162), P = 0.003] and month 6 [25 (20–31) vs 21% (17–27), P = 0.02], respectively. At study end, Hb did not differ between groups (121 ± 10 vs 117 ± 13 g/L). Ferritin was 362 (310–458) vs 125 µg/L (84–190), P 110 g/L.
    Original languageEnglish
    Pages (from-to)920-926
    JournalNephrology, Dialysis, Transplantation
    Volume25
    Issue number3
    DOIs
    Publication statusPublished - 2010

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