Iron and ferritin status in hemodialysis patients under darbepoetin alfa therapy

摘要

It is well known, that iron status is often disturbed in patients undergoing regular hemodialysis treatment. Additionally, these patients suffer from anemia due to erythropoietin loss. Darbepoetin alfa therapy is a novel erythropoietin stimulating regimen. Only sparse data exist concerning iron metabolism and demand under darbepoetin alfa therapy. Therefore it was of interest to study iron and ferritin in hemodialysis patients before and after darbepoetin alfa therapy. 29 patients under regular hemodialysis treatment were investigated before and after a 40 weeks darbepoetin alfa therapy (10-60 μg darbepoetin alfa/week). In each patient iron and ferritin was measured. The results show that iron was 735 +/- 364 μg/l before therapy versus 614 +/-242 μg/l after therapy (means +/- SD, p < 0.05, paired t-test). Ferritin values were not significantly different (905 +/- 394 versus 953 +/- 437 μg/l). All patients were on iron supplementation (20-120 mg sodium ferric gluconate in sucrose injection per week on average). The results show that iron demand under regular hemodialysis conditions and darbepoetin alfa therapy is increased. Therefore a combined therapy with iron and darbepoetin alfa is necessary in patients undergoing regular hemodialysis treatment.