In cardio-renal patients, target hemoglobin can be met with intravenous iron alone

At ESC, held in August-September in Amsterdam, researchers from the Tel Aviv Sourasky Medical Center presented their poster showing that, in cardio-renal patients, target hemoglobin can be met with intravenous iron alone. This treatment strategy may reduce the use of erythropoietin stimulating agents (ESA) and their adverse effects.

They evaluated a total of 81 patients over a two-year period. Of them, 47 were given IV iron and ESA (group A) and 34 received IV iron alone (group B). The baseline characteristics were similar in both groups, with a mean age 75 +/- 9.7 years, mean ejection fraction 37 +/-15.2%,  and mean estimated glomerular filtration rate of 26 +/- 12.6 ml/min/1.73m2. Hemoglobin (Hgb) levels significantly increased in both groups (10.3 +/- 0.9 to 12.4 +/- 1.3 g/dl,  P=0.004 and 10.6 +/- 1.1 to 11.9 +/- 1.1 g/dl, P=0.001,respectively), more pronouncedly in group A (2.17 vs 1.36 g/dl, P=0.008).

The net ferritin augmentation was greater in group B (308.5 vs 161.6 ng/mL, P=0.002).Platelet count decreased significantly in group B (225 +/- 69 to 199 +/- 51 ×109/L, P=0.02) while unchanged in group A (219 +/- 63 to 216 +/- 55 ×109/L, P=0.54). Independent predictors of a favorable outcome to treatment were low baseline hemoglobin and MCV levels.