Bolus intraperitoneal iron versus intravenous iron in peritoneal dialysis patients: a prospective study

Abstract

Anemia in peritoneal dialysis (PD) is related to impaired erythropoiesis and/or iron deficiency. Oral iron is insufficient to supply adequate acces- sible iron to patients with end-stage renal failure. Intermittent intra- venous (IV) iron supplementation is effective but inconvenient in PD patients. Intraperitoneal (IP) iron may present a more convenient method of administration. In this study, we examined the efficacy of IP iron dextran in comparison with IV iron. Prospective randomized and cross- over studies were carried out. Patients with a serum ferritin less than 200 µ g/L, with no contraindications, were randomized to receive either IP or IV iron. Patients randomized to IP iron were subsequently crossed over to receive IV iron. Analysis using the t -test and Mann–Whitney U test of 16 patients (12 IP and 15 IV) was performed. IP iron did not produce an increase in storage or utilizable iron in PD patients. Hemoglobin (Hb) concentrations and erythropoietin (EPO) dose were unaffected. IV iron produced a significant increase in both circulating and storage iron, with a significant rise in Hb concentrations and no change in EPO requirements. No adverse events occurred after a total of 81 doses of iron therapy. These data suggest that IP iron in this group of patients offers no clinical efficacy in PD patients.