Recombinant Human Erythropoietin Factors Combined Oral Andintravenous Iron Therapy In The Elderly To Maintain The Efficacy Of Hemodialysis Patients With Anemia Andsecurity

ObjectiveAnemia is one of the most common complications of chronic renal disease,which exists in the majority of patients with maintenance hemodialysis.Nowadays, it is very coomon to use EPO and iron to treat patients with renalanemia in clinical. The effect of these drugs are effectually in some patients,but some other still can not meet the minimum hemoglobin (Hgb) value byoral iron therapy. K/DOQI point out that intravenous iron therapy is good forrenal anemia paithents, which can prevent and remedy iron deficiency.However, some research show that intravenous iron therapy may have effect onthe microinflammation state of patients with maintenance hemodialysis. Weanalyzed clinical data of60middle-and-old-aged patients undergoingmaintenance hemodialysis. To evaluate the efficacy and safety of Intravenousiron therapy with rHuEPO and with rHuEPO for CKD anemia。MethodsSixty old hemodialysis patients with renal anemia, those who meet thefollowing criteria were selected:(1) maintenance hemodialysis patients, dialysis2~3times peer week, at the age of45to85years old.(2) the Hb levels were60~90g/L.(3) serum iron protein (SF)<300μ g/L, transferrin saturation (TSAT)less than20%. Exclusion criteria:(1) iron agent allergy.(2) those who sufferfrom serious secondary hyperparathyroidism, severe liver disease, active ulcer disease, asthma, arthritis, tumor, acute or chronic blood loss, the severemalnutrition.(3) those who have blood transfusion in a month or the history ofintestinal iron agent application (4) have the acute or chronic severeinfections.These patients were randomized into two groups： Intravenous irongroup（IV group） with100mg iron sucrose peer week and Oral iron group（Oralgroup） ferrum dextran iron every with200mg day. The changes inhemoglobin （Hb），he-matocrit （Hct），serum ferritin（SF），and transferrinsaturation （TSAT） were assessed on week4，8，and12after treatment. Themaintenance dosages of erythropoietin（EPO） after reaching treatment targetand the adverse events were also observed.ResultsThere was higher increase of Hb（25.6g/L） and SF（381.22ug/L） in IVgroup compared with Oral group（P＜0.0l）. The adverse events was lower in IVgroup than in Oral group（0vs16.6%， P＜0.05）.ConclusionsOral iron which has more adverse events and poor efficacy in curinganemia that cannot correct anemia ideally. Meanwhile intravenous iron sucrosehas positive effects on renal anemia with low adverse events， and it can be usedas a long term iron supplementation in hemodialysis patients.