The absorption of iron is disturbed in recombinant human erythropoietin-treated peritoneal dialysis patients

Abstract

Background. Intravenous iron supplementation is often necessary in recombinant human erythropoietin (r-HuEPO)-treated haemodialysis (HD) patients, but rarely in r-HuEPO-treated peritoneal dialysis (PD) patients. This may be due to differences in iron absorption or blood loss. Method. Iron absorption (whole-body counting after ingestion of a radiolabelled iron test dose) and iron metabolism were compared in eight iron-replete r-HuEPO-treated PD patients (serum ferritin 100-500 μg/l) and 68 healthy iron-replete controls (sufficient iron in bone marrow specimen). Results. Mucosal uptake (13.4 ± 9.8%), mucosal transfer (0.34 ± 0.18) and iron retention (4.9 ± 4.0) in PD patients was significantly lower than in controls (42.9 ± 18.8%, P < 0.0001, 0.63 ± 0.18, P < 0.0001, and 28.0 ± 16.7%, P < 0.0001). Conclusion. Iron absorption is impaired in PD patients, as we have shown previously for HD patients. One reason for higher iron needs in HD patients may be higher blood losses due to the dialysis procedure and blood sampling for laboratory tests.