Minimal removal of iron-dextran by conventional haemodialysis. An in vivo study

Abstract

Iron-dextran may be administered during haemodialysis by slow infusion through the venous access port for the management of iron deficiency in patients treated with erythropoietin. This technique is time-efficient and convenient. The degree to which haemodialysis removes iron-dextran in vivo, however, is unknown. The purpose of this study was to measure the removal of iron-dextran in patients undergoing haemodialysis. Eight patients were enrolled into this open label, single dose, mass transfer study. All were stable patients, treated by haemodialysis for at least 1 month and with a stable baseline average haematocrit of 30.9 ± 1.9%. All 8 patients used a Terumo® 175 cuprammonium dialyser and all received 1 g of intravenous iron-dextran infused over 1 hour during dialysis. Dialysate was collected for an average of 160 ± 30 minutes, was concentrated by lyophilisation, and assayed for iron-dextran content by spectrophotometry. The amount of iron-dextran removed by haemodialysis was determined. Six of the 8 patients showed no detectable amounts of iron-dextran in the dialysate, while 2 showed less than 2% of the total dose given. Haemodialysis removed 5 mg of iron during a 110-minute session in 1 patient, and 17 mg of iron during a 188-minute session in a second patient. Both patients were dialysed with the Terumo® 175 dialyser, reprocessed once. Our study concluded that there is minimal removal of iron-dextran by conventional haemodialysis in vivo. Administration of iron dextran during haemodialysis is convenient and efficient, and does not warrant a change in dosage schedule.