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TIMOTHY V. NGUYEN, PHARM.D., CCP, FASCP, is Clinical Pharmacy Specialist, Nephrology and Dialysis, Department of Pharmacy, Holy Name Hospital, Teaneck, NJ; Adjunct Assistant Professor, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway; and Adjunct Pharmacology Professor, Saint Peter’s College, Englewood, NJ.

Address correspondence to Dr. Nguyen at the Department of Pharmacy, Holy Name Hospital, 718 Teaneck Road, Teaneck, NJ 07666 (tnguyen{at}spc.edu).

Purpose. The effects of i.v. iron formulations on serum ferritin concentration (SFC) and transferrin saturation (TSAT) are compared in adult hemodialysis patients with anemia receiving erythropoiesis-stimulating agents (ESAs). Methods. This study consisted of 215 patients who were receiving chronic hemodialysis, ESAs, and i.v. iron supplementation from November 2005 to November 2006. All patients received iron sucrose therapy from November 2005 to April 2006. Patients were then switched to sodium ferric gluconate. If the patient’s SFC was <100 ng/mL and TSAT was <20%, then iron sucrose 100 mg i.v. at every hemodialysis for 10 doses or sodium ferric gluconate 125 mg i.v. at every hemodialysis for 8 doses was administered as loading doses. Maintenance doses of iron sucrose 60 mg or sodium ferric gluconate 62.5 mg were administered every two weeks if the SFC was 100–499 ng/mL and the TSAT was 20–29% or every four weeks if the SFC was 500–600 ng/mL and the TSAT was 30–45%. SFC and TSAT were measured every three months. Results. More treatment courses resulted in target SFC and TSAT values during treatment with sodium ferric gluconate than iron sucrose, but neither difference was significant. The proportion of treatment courses resulting in SFCs of >600 ng/mL (above the target range) was significantly greater during treatment with iron sucrose than sodium ferric gluconate. Conclusion. There was no significant difference between iron sucrose and sodium ferric gluconate in the frequency in which SFC and TSAT values were within target ranges in hemodialysis patients with anemia receiving ESAs. Of the two drugs, iron sucrose was more likely to produce an SFC above the target range. Index terms: Anemia; Dialysis; Drug comparisons; Injections; Iron preparations; Iron sucrose; Kidney failure; Sodium ferric gluconate