Intramuscular iron replenishment and replacement combined with testosterone enanthate in maintenance hemodialysis anemia: a follow-up of up to 8 years on 16 patients.

Sixteen chronic uremics who showed exhausted bone marrow iron stores and mean hematocrit values of 20.9 +/- 4.2% at the time of starting maintenance hemodialysis (HD) were treated by means of intramuscular iron dextran (IMD) (400 mg/month) for six months. By the end of this replenishment period, stainable bone marrow iron was observed and mean hematocrit values increased to 27.2 +/- 4.9% (p greater than 0.001). At this time, 200 mg of IMD/month and testosterone enanthate (1.5 g/month) were prescribed for the whole follow-up period (up to 8 years). The observed mean hematocrit values were up to 46.1 +/- 1.6%. Major side effects were not observed. The process of slow iron reabsorption from the intramuscular injection site (up to 4 weeks) also implies the splitting of iron from dextran, therefore preventing bone marrow deposits of iron dextran complexes which make iron unavailable for erythropoiesis. High doses of testosterone enanthate can normalize hematocrit values of maintenance hemodialysis patients with replenished bone marrow iron stores.