Maeda Institute of Renal Research, 6F-1-403 Kosugi-cho, Nakahara-ku, Kawasaki 211-0063, Kanagawa, Japan.
Biomarker Society, INC, 6F-1-403 Kosugi-cho, Nakahara-ku, Kawasaki 211-0063, Kanagawa, Japan.
Int J Mol Sci. 2024 Jan 25;25(3):1508. doi: 10.3390/ijms25031508.
In vivo iron levels can be adjusted through intestinal iron absorption to be maintained at a suitable level; however, optimal iron levels in hemodialysis (HD) patients are unclear. In this study, we investigated total body iron (TBI), calculated as the sum of red blood cell (RBC) iron and iron stores, during courses of low-dose oral iron replacement therapy, and evaluated in vivo iron sufficiency and its indicators in HD patients. We analyzed data on 105 courses of low-dose iron replacement therapy administered to 83 patients on maintenance HD over 7 months. We evaluated changes in TBI, RBC iron, and iron stores from the initiation of treatment to month 7 in two groups of patients, namely, iron-therapy responders and non-responders. TBI showed significant increases until month 4 and plateaued thereafter in iron-therapy responders, and tended to increase and then reached a similar plateau in non-responders (month 7: 1900 ± 447 vs. 1900 ± 408 mg). Steady-state TBI was strongly correlated with body surface area (y = 1628.6x - 791.91, R = 0.88, < 0.001). We observed constant TBI during oral iron replacement therapy suggesting the activation of a "mucosal block". The results suggest that body surface area has utility for estimating the required TBI with regression equations.
体内铁水平可以通过肠道铁吸收进行调节，以维持在适当的水平；然而，血液透析（HD）患者的最佳铁水平尚不清楚。在这项研究中，我们在低剂量口服铁替代治疗过程中研究了总铁量（TBI），即红细胞（RBC）铁和铁储存量的总和，并评估了 HD 患者体内铁的充足性及其指标。我们分析了 83 名维持性 HD 患者在 7 个月内接受 105 个低剂量铁替代治疗疗程的数据。我们评估了铁治疗反应者和非反应者两组患者从治疗开始到第 7 个月时 TBI、RBC 铁和铁储存量的变化。在铁治疗反应者中，TBI 直到第 4 个月显著增加，此后趋于稳定，而非反应者则呈增加趋势，然后达到类似的稳定状态（第 7 个月：1900 ± 447 与 1900 ± 408 mg）。稳态 TBI 与体表面积呈强烈相关（y = 1628.6x - 791.91，R = 0.88，< 0.001）。我们观察到在口服铁替代治疗期间 TBI 保持稳定，这表明激活了“黏膜阻塞”。结果表明，体表面积对于用回归方程估计所需的 TBI 具有实用性。
