CHRONIC RENAL FAILURE

TREATMENT OF ANEMIA WITH ERYTHROPOIETIN AND IRON

Abstract

Objectives: This study on anemia in chronic
renal failure patients was aimed at evaluation and comparison of response to erythropoietin therapy in iron deficient
groups treated with parenteral vs iron deficient group treated with oral iron ; keeping iron replete patients as controls.
Study design: Study design was case control study. Place and duration of study: The study was carried out at
department of medicine Military hospital Rawalpidi and Armed forces institute of Urology; from 1997-1998.
Subject/Methods: A total of 59 patients were recruited. Comparison of the change in hemoglobin, hematocrit, and
reticulocyte count and serum ferritin levels was made. They were divided into three groups based on their serum ferritin
levels. Group I (n=18) and group II (n=16) consisted of iron deficient patients. Group III (n=25) consisted of iron-loaded
individuals and they were treated with erythropoietin alone. This group acted as the control group for the study.
Results: The hematocrit increased by an average of 6% in group I, 2% in group II and 5% in group III. The serum
ferritin levels increased by an average of 147.51 μg/l in group I. Group II on oral iron showed an increment of only 77.1
mg/l. Group III that consisted of iron loaded patients showed a decrease of 594.2 mg/l in serum ferritin levels while on
erythropoietin. Conclusions: (i) It was concluded that erythropoietin improved anemia in patients with chronic renal
failure, parenteral iron having a definitive advantage over oral iron therapy. This response is augmented by
supplementing iron in iron deficient patients. (ii) Conversely, functional iron deficiency, i.e. the inability to utilize iron
in iron replete patients for erythropoiesis exhibit improvement with erythropoietin therapy.