Comparative study of the therapeutic effect of 3 intravenous iron preparations in patients with renal anemia

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  • 腎性貧血に投与した３種類の静注用鉄剤の治療効果の比較検討
  • ジンセイ ヒンケツ ニ トウヨシタ 3シュルイ ノ ジョウチュウヨウ テツザイ ノ チリョウ コウカ ノ ヒカク ケントウ

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Abstract

Intravenous iron preparations and rHuEPO are important in the treatment of anemia in hemodialysis patients. It is generally considered that all intravenous iron preparations are the same in terms of effect. However, we have found differences between saccharated ferric oxide and cideferron. Specifically, a larger than anticipated increase in serum ferritin was observed with a dose reduction in the iron preparation and rHuEPO. In this study, three iron preparations (saccharated ferric oxide, cideferron, iron chondroitin sulfate) were administered for one year each for a total of three years to 86 patients undergoing chronic dialysis, and various parameters (Ht, Hb, iron preparation dose, serum ferritin, MCV, rHuEPO dose) during each treatment period were compared. The same patients were used throughout the study. Each week, the rHuEPO dose for the following week was determined in accordance with our established dosage nomogram based on hematocrit (Ht) value. Iron dose was based on ferritin concentration, measured monthly. It was shown that the mean Ht concentration was maintained at about 30% during the 3-year period, with the highest levels were observed during treatment with cideferron. During this period, hemoglobin levels were also the highest and a significant increase in serum ferritin as well as increased mean corpuscular volume (MCV) were observed. To maintain the ferritin concentration, cideferron required the lowest dose. During treatment with cideferron, the rHuEPO dose was significantly lower than that during treatment with saccharated ferric oxide but the same as that during treatment with iron chondroitin sulfate. In summary, despite administering a lower dose, cideferron was most effective in increasing serum ferritin. Since the increase in serum ferritin coincided with a decreased rHuEPO dose, we concluded that a definite increase in serum ferritin levels could be achieved by rHuEPO dosage reduction.

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