IRON THERAPY TO OPTIMIZE EFFICACY AND COST OF IRON DEFICIENCY ANEMIA, A DIALYSIS CENTER EXPERIENCE

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IRON THERAPY TO OPTIMIZE EFFICACY AND COST OF IRON DEFICIENCY ANEMIA, A DIALYSIS CENTER EXPERIENCE

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Co-author 1

Mohammed Alomi malomi@moh.gov.sa Riyadh second health cluster King salman dialysis center Riyadh Saudi Arabia -

Co-author 2

Abdulaziz Alshalaani aalshalaani@moh.gov.sa Riyadh second health cluster Zulfi general hospital Alzulfi Saudi Arabia -

Co-author 3

Hamdan Alzunaidi halzonaide@moh.gov.sa Riyadh second health cluster Zulfi general hospital Alzulfi Saudi Arabia -

Co-author 4

Chamel Kat sqat@moh.gov.sa Riyadh second health cluster Zulfi general hospital Alzulfi Saudi Arabia -

Co-author 5

Ahmed Almatq aalmatq@moh.gov.sa Riyadh second health cluster Zulfi general hospital Alzulfi Saudi Arabia -

Co-author 6

Aiysha Abdulraheem asabdulraheem@moh.gov.sa Riyadh second health cluster Zulfi general hospital Alzulfi Saudi Arabia -

Co-author 7

aamra saidahmed asaidahmed@moh.gov.sa Riyadh second health cluster Zulfi general hospital Alzulfi Saudi Arabia -

Co-author 8

ali altayyar amaltayyar@moh.gov.sa Riyadh second health cluster Zulfi general hospital Alzulfi Saudi Arabia *

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Anemia is very common in patients undergoing hemodialysis. The main cause is iron deficiency anemia. Erythropoietin deficiency is another major cause of anemia. Maintaining sufficient iron stores while using the lowest epoetin dose is the main therapeutic goal in hemodialysis patients to avoid the side effects of epoetin.

Methods

This was an observational, retrospective, single-center study conducted in hemodialysis patients. The patients were reviewed at two intervals. First from May-2024 to September-2024 and the second period from October-2024 to February-2025 after application of the iron dosing protocol as a proactive and reactive pattern according to laboratory results of hemoglobin, ferritin, and transferring saturation. The aim was to reduce the cost of epoetin by using iron therapy in the best up- to- date standards of care.

Results

The hemoglobin level was maintained at the target level during all study periods. There was significant reduction in epoetin dose by 31.5%, which resulted significantly in cost reduction with almost same amount of iron dose given in both interval periods, indicating that the way and methodology of giving iron is very important. There was an important observation in safety end points monitoring, which is a reduction in the incidence of impaired liver function events after reduction of epoetin dosing.

Conclusion

The proactive use of intravenous iron led to a significant reduction in epoetin cost without concerns regarding the side effects of intravenous iron.

Kewords