Abstract
The effects on erythropoiesis, iron metabolism, and oxidative stress of differences in iron preparation administration methods by intravenous injection were investigated for hemodialysis patients undergoing CERA treatment. The subjects comprised 20 hemodialysis patients undergoing CERA administration once in 4 weeks with sFtn below 100 mg/dL. The subjects were divided into 2 groups : those repeatedly administered Fesin® at 40 mg 8 times, once a week, from the CERA administration date (repetitive group), and those administered it 2 times, once a week, from the CERA administration date and subsequently repeating 2-week drug withdrawal, totaling 8 administrations (non-repetitive group). Hb, Ret, sFe, TSAT, Hep-25, CHr, sFtn, sTfR, and 8-OHdG before and after administration were chronologically measured. Ret increased in both groups, peaking one week after CERA administration. The sFe, TSAT, Hep-25, and CHr values showed declining patterns 1 to 2 weeks thereafter, and then increased 3 to 4 weeks thereafter in both groups, with no significant difference between the groups. The sFtn value significantly increased following iron preparation administration compared with that before administration in the repetitive group, but not in the non-repetitive group. The value was high at weeks 3 to 9 in the repetitive group. The 8-OHdG value was significantly high but within the normal range before iron preparation administration, exhibiting no significant changes during follow-up or significant differences between the two groups. One period showed accelerated erythropoiesis following CERA administration, causing iron deficiency despite intravenous injection of the iron preparation. Such iron deficiency could not be prevented by repetitive or non-repetitive administration ; moreover, the dosage was insufficient in non-repetitive administration for supplementing stored iron. The development of an iron preparation administration method by intravenous injection conforming to CERA drug properties is required.
