Hemodialysis Clinical Trial
Official title:
Effect of IVIR Frequency on Anemia Correction and Oxidative Stress Formation and in Hemodialysis Patients
The purpose of this study is to determine whether the frequency of intravenous iron administration has an effect on anemia correction and oxidative stress formation in hemodialysis patients.
In patients who are on chronic hemodialysis (HD), anemia is a major complication and is
associated with poor clinical outcomes. Consequently, management of anemia by recombinant
erythropoietin is reported consistently to improve outcome measures in HD patients. Because
iron is essential for hemoglobin formation, as is erythropoietin, most patients routinely
receive iron intravenously (IVIR) for anemia correction. Although IVIR has been shown to
improve both survival and quality of life of HD patients, it has been suggested that IVIR
may enhance the generation of hydroxyl radicals in the body through the inflammation process
and the Fenton reaction. Previously we demonstrated that that serum albumin is highly
oxidized in HD patients and that IVIR on these patients significantly increased the
oxidation status of albumin.
In 2004, the committee on the guidelines of the Japanese Society for Dialysis Therapy (JSDT)
published the original Japanese "Guidelines for Renal Anemia in Chronic Hemodialysis
Patients". In the JSDT guidelines 2004, the committee recommended two IVIR schedules for
iron deficient patients; 1) administer 40 mg of IV iron at the end of dialysis session 3
times a week for 4 weeks (total 520 mg of iron), 2) administer 40 mg of IV iron at the end
of dialysis session once a week for 3 months (total 520 mg of iron). Both administration
schedules are effective for the correction of iron deficiency and consequently for the
amelioration of anemia. However, the effect of IVIR frequency (three times a week vs. once a
week) on the oxidative stress formation has not been investigated before.
Comparison: the two IVIR schedules recommended by the JSDT guideline 2004 will be compared
by measuring both hemoglobin and oxidized albumin in chronic HD patients.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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