Intravenous iron treatment effect to patients on hemodialysis
Vaida Kazlauskaite, , Skirmante Rekute
Vilnius University, Faculty of Medicine, Lithuania

Aim: To evaluate the coherence between intravenous iron therapy and the inflammatory indicators to patients on hemodialysis.

Introduction: when the kidney function is failing, the number, of patients who has a final stage kidney disease with anemia, is increasing. One of the most important reasons of anemia is iron deficiency. The iron treatment may be intravenous or oral. Though the oral treatment is cheaper, it may cause gastrointestinal disorders. Intravenous iron therapy has a better tolerance, but earlier studies had showed that it increases the risk of infections to patients on hemodialysis.

Methods: The retrospective study included 33 hemodialysis patients who undergone the intravenous therapy during the 2016-10 and 2016-12 in Vilnius university hospital. The absolute numbers of neutrophils and lymphocytes, C-reactive protein and procalcitonin were assessed before the treatment with intravenous iron and a month after it.

Results: we analyzed 13 men and 20 women, the mean age 59 years, the mean creatinine 760μmol/l, the mean hemoglobin 105g/l. By the test of Wilcoxon signed rank the means of neutrophils and C-reactive protein increased after the start of the treatment with iron (the mean of C-reactive protein increased from 12.8±12.96 to 27.4±41.17; p=0.07; the mean of neutrophils increased from 4.45±1.52 to 6.86±12.11; p=0.59). The T-test showed that the means of procalcitonin increased from 0.21±0.07 to 0.23±0.08, p=0.04, the mean of lymphocytes increased from 1.35±0.54 to 1.54±0.62, p=0.1. Pearson correlation coefficient showed statistically insignificant positive correlation between the dose of medication and variation of procalcitonin.

Conclusion: The study has showed that inflammatory indicators increased after the intravenous iron therapy to patients on hemodialysis.

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