OBJECTIVE: Oral iron is poorly absorbed in chronic dialysis patients. We tested the hypothesis that a superpharmacologic dose of iron sulfate (260 mg elemental iron) administered on an empty stomach results in significant iron absorption in these patients. DESIGN: A prospective open controlled trial. SETTING: Outpatient department of a university hospital. PATIENTS: Nine stable chronic peritoneal dialysis (PD) patients and seven normal control subjects. METHOD: All subjects ingested a single dose of 4 tablets of iron sulfate (260 mg elemental iron total) in the morning while fasting. OUTCOME MEASURES: Serum iron concentrations at baseline, and at 2 and 4 hours after the oral dose were compared between the two groups. RESULTS: The control group showed a significant rise in mean [standard error (SE)] serum iron concentration, from a baseline value of 76.5 +/- 7 microg/dL to 191 +/- 10.5 microg/dL at 2 hours and to 190 +/- 24 microg/dL at 4 hours. This result represents a percentage rise of 164% +/- 32% at 2 hours and 152% +/- 28.5% at 4 hours. In the PD patients, a significant rise in serum iron concentration was also seen, from a baseline value of 64 +/- 8 microg/dL to 130 +/- 3 microg/dL at 2 hours and 111 +/- 18 microg/dL at 4 hours. This result represents a percentage rise of 105% = 29% at 2 hours and 77% +/- 23.5% at 4 hours. However, the absolute change in serum iron concentration in PD patients at 2 and 4 hours was approximately equal to 50% of the change in control subjects at those time points. None of the PD patients experienced gastrointestinal side effects; 4 control subjects experienced mild side effects. CONCLUSION: Despite impaired oral iron absorption in chronic dialysis patients, a large pharmacologic dose given orally can result in significant iron absorption and may prove to be a more efficient means of oral iron supplementation therapy in these patients.

Copyright © 2000 by Multimed Inc.