TOTAL DOSE IRON INFUSION: SAFETY AND EFFICACY IN PREDIALYSIS PATIENTS

Iron deficiency anemia isnot uncommon in predialysis patients. Oral iron often cannot maintain adequate iron stores. Hence we evaluated the safety and efficacy of total infusion (TDI) of iron in these patients. Anemic predialysis patients were screened and those with Hb < 7.0g dL and serum ferritin < 200ng mL were selected. Patients with active bleeding and acute livere disease were excluded. All patients were on oral iron 100mg day. None of the patients were on erytropoeitin. 11 patients (6 males and 5 females). aged 45.9 + 15yrs. were suitable. Hb was 5.9 ± 1.0g dL and serum ferritin was 89.5 + 50 ng mL. The preparation used was iron dextran. A test dose of 25mg in 100mL normal saline was administeted over 1 hr to all patients. One patient had fever and chills during the test dose and was not given TDI. 10 patients received TDI. None of these patients had any problem during the infusion. The dose of iron administered was 900 + 316.2 mg. One patient who received 1600mg had arthralgia-myalgia and another patient had thrombophlebitis following TDI. One month after TDI, Hb was 8.0 + 1.0g dL and serum ferritin was 362ng mL. We feel that TDI is a safe and effective method of correcting iron deficiency in predialysis patients.