Maintenance intravenous iron sucrose therapy in children under regular hemodialysis

This study aimed to evaluate the effects of maintenance IV iron sucrose vs oral iron gluconate on iron indices and hematological profile in pediatric hemodialysis patients. Twenty four children under regular hemodialysis (13 males and 11 females with median age 11 years) were enrolled in this study and had initial adequate iron stores and were maintained on oral iron gluconate daily and erythropoietin alpha (EPO) weekly for 3 months prior to study. They were randomly subdivided into two groups. Group A included 12 patients (8 males and 4 females with median age 10 years) and they continued to receive oral iron gluconate daily and EPO alpha and group B included 12 patients (5 males and 7 females with median age 12 years) who received intravenous iron sucrose every 2 weeks and EPO alpha on same dose of group A for a study period of 3 months. There were significant increase in serum iron (p = 0.002), serum ferritin (p = 0.026) and transferrin saturation (p = 0.001) in (IV) iron sucrose group than with oral iron gluconate group. In addition, hemoglobin and hematocrite were increased by 8 and 11.2%, respectively on group B. Iron overload was reported in two patients only of group B (16.7%). We concluded that IV iron sucrose is effective and safe preparation to be used in iron replete children under regular hemodialysis to maintain adequate iron stores and to ensure optimum response to EPO therapy.