Haemoglobin response to intravenous iron in non-dialysis patients with chronic kidney disease and diabetes

Abstract

Aims. Our aim is to compare the response of people with or without diabetes to intravenous iron and to evaluate the efficacy of this therapy in improving haemoglobin (Hb) levels in non-dialysis patients according to chronic kidney disease (CKD) stage.

Method. This was a prospective study of 100 consecutive adult patients referred to the renal anaemia service for intravenous iron. Patients with other causes of anaemia or receiving erythropoietin therapy were excluded. Patients were given weekly intravenous doses of 200 mg iron sucrose for 4 weeks and monitored at weeks-1 and 5. Data, including diabetic/CKD status, were collated from patient records. Results. Pre-treatment Hb was similar in people with and without diabetes and treatment significantly increased Hb levels (0.5 g/dL, p<0.003 and 0.5 g/dL, p<0.0001 respectively). Pre-treatment transferrin saturation and the proportion of hypochromic red cells were not significantly different between the groups. Hb levels rose more in CKD stages 3 (0.5 g/dL, p<0.05) and 4 (0.6 g/ dL, p<0.02) than in stage 5 (-0.1 g/dL).

Conclusion. CKD patients with or without diabetes have similar iron status and Hb response to intravenous iron therapy. Patients with CKD stage 5 respond less well to intravenous iron than patients with CKD stages 3 or 4, despite having similar baseline iron status.