Korean Journal of Nephrology 1997;16(4):753-759.

Recombinant Human Erythropoietin을 투여받는 혈액투석 환자에서 정주 철분 제제의 유용성

박광재 , 강재영 , 최재원 , 양원석 , 김순배 , 박정식 , 홍창기

Abstract

Compared with iron dextran, iron chondroitin sulfate(ICS) is much cheaper and has better bioavaila- bility. To evaluate the efficacy and safety of ICS in maintenance HD patients, I.v. ICS was given to 37 HD patients [20 M, 17 F, median age 51 years, me- dian duration of HD 21 months] whose ferritin(Fer)< 100 m g/L or transferrin saturation(TFS) <20%[Group I, 12 M, 10 F] or Hb<9.0g/Dl in spite of increased rHuEPO dose, Fer>=100pg/L and TFS>=20% [Group II, 8 M, 7 F]. The patients had taken oral iron [227± 73mg/day(mean±SD)] before this study. All patients received 120mg I.v. ICS weekly for 1 month. Then, ICS dosage was adjusted to 40-120mg/week depending on Hb, Fer and TFS in the following 3 months. Hb, Fer, TFS, rHuEPO dose and side effects were monitored monthly. The results were as follows ' 1) I.v. iron therapy produced a significant rise in Hb(8.3±0.9g/Dl to 9.7±0.9g/Dl; P<0.01), a signifi- cant reduction in rHuEPO dose(95±50U/kg/wk to 69± 28U/kg/wk; P<0.05), a significant increase in se rum ferritin levels(162±149 m g/L to 472±255 p g/L; P<0.01) and TFS(24±13% to 41±18%', P<0.05). 2) In group 1, I.v. iron therapy produced a signi ficant rise in Hb(8.5±1.lg/Dl to 9.9±0.9g/Dl; P< 0.01), a significant reduction in rHuEPO dose(87± 45U/kg/wk to 69±27,U/kg/wk; P<0.05), increased serum ferritin levels(90±48pg/L to 379±186mg/L; P<0.01) and TFS(18±9% to 36±16%6; P<0.05). 3) In group 2, I.v. iron therapy produced a signifi- cant rise in Hb(8.10.6g/dL to 9.30.9g/dL; P<0.01), a significa@nt reduction in rHuEPO dose(108+55U/kg/ wk to 69±31U/kg/wk; P<0.05) and increased serum ferritin levels<274185pg/L to 602 287pg/L; P< 0.01) with a tendency of increase in TFS(35±13% to 41±18%; P=0.06). 4) No significant side effect was observed. 5) An annual cost reduction of 221 US dollars per patient was expected. In conclusion, ICS is an effective and safe intravenous iron preparation in HD patients.