Assessment of Haemoglobin Response to Intravenous Iron Therapy in Non-Dialytic Chronic Kidney Disease Patients With Anaemia

Abstract

BACKGROUND There is difficulty in assessing iron status in Chronic Kidney Disease (CKD) patients with anaemia, because of functional iron deficiency. The aim of the study was to assess Haemoglobin (Hb) response to Intravenous (IV) iron therapy in CKD patients with anaemia and correlate Hb response with available iron indices. MATERIALS AND METHODS The study is a clinical, prospective, observational study. Forty newly detected CKD patients with GFR < 30 mL/min/1.73 m 2 and Hb < 10 g/dL were included in the study. Ten daily doses of 100 mg Intravenous (IV) iron sucrose injections were administered without erythropoietin when Transferrin Saturation (TSAT) was < 30% irrespective of serum ferritin levels. Their Hb and iron indices responses were assessed one month after the last dose of IV iron. The sample size required was taken for convenience. RESULTS There was a 0.8 g/dL Hb increase. Hb response was more when TSAT was less than 20%. There was Hb response even if serum ferritin was more than 500 ng/mL, when TSAT was less than 20% and when TSAT was 21-30% moderate. Hb response was present if serum ferritin was < 500 ng/mL and no Hb response if serum ferritin was > 500 ng/mL. CONCLUSION TSAT < 20% is a better predictor of Hb response in non-dialytic CKD patients with anaemia. Treatment with 1 g IV iron sucrose is beneficial in non-dialytic CKD patients with anaemia in spite of high serum ferritin levels when TSAT is < 20%. Further studies are needed in this regard.