Abstract
The usefulness of sodium ferrous citrate administration was investigated in 31 hemodialysis patients with an iron saturation index (FeSI) below 16%. Patients receiving recombinant erythropoietin (rEPO) therapy showed a significant increase in Hb with ferrous citrate administration. In contrast, the group administered iron alone showed no significant change in Hb, suggesting that iron is not utilized effectively for hematopoiesis. Patients with ferritin (Frt) levels below 50ng/ml showed better responses to ferrous therapy than those whose Frt exceeded 50ng/ml. The low response group for rEPO (Hb≤8.5g/dl) had a significant increase in Hb after ferrous administration, but the high response group for rEPO (Hb>8.5g/dl) showed no change.
Hypochromic microcytic anemia was observed in only 2 patients (6%), while most (68.7%) of the patients had normochromic normocytic anemia. At 3 months after administration, 10 patients (32%) showed a more than 1g/dl increase in Hb, and 8 of these patients demonstrated nonhypochromic and/or nonmicrocytic anemia. These results suggest that it is difficult to determine iron deficiency by MCV, MCH, Fe or FeSI and Frt level below 50ng/ml is considered to be a more precise marker for iron deficiency.
