Iron deficiency anemia is not uncommon in predialysis patients. Oral
iron often cannot maintain adequate
iron stores. Hence we evaluated the safety and efficacy of total dose infusion (TDI) of
iron in these patients. Anemic predialysis patients were screened and those with Hb < 7.0 g/dL and serum
ferritin < 200 ng/mL were selected. Patients with active
bleeding and acute
liver disease were excluded. All patients were on oral
iron 100 mg/day. None of the patients were on erythropoeitin. 11 patients (6 males and 5 females), aged 45.9 +/- 15 yrs, were suitable. Hb was 5.9 +/- 1.0 g/dL and serum
ferritin was 89.5 + 50 ng/mL. The preparation used was
iron dextran. A test dose of 25 mg in 100 mL
normal saline was administered over 1 hr to all patients. One patient had
fever and
chills during the test dose and was not given TDI. 10 patients received TDI. None of these patients had any problem during the infusion. The dose of
iron administered was 900 + 316.2 mg. One patient who received 1600 mg had
arthralgia-
myalgia and another patient had
thrombophlebitis following TDI. One month after TDI, Hb was 8.0 + 1.0 g/dL and serum
ferritin was 362 ng/mL. We feel that TDI is a safe and effective method of correcting
iron deficiency in predialysis patients.