Wednesday March 28, 2007
Epogen and Iron

Erythropoetin (Epogen/Procrit) will not work if patient's Iron level is low. But important points to remember:

• Simply checking Fe level may not provide reliable answer to Fe storage 1.
• Erythropoetin, by stimulating erythropoiesis to greater than physiologic level, may itself induce iatrogenic functional iron deficiency.
• Oral iron may take longer and may not satisfy the requirement and extra dose of IV iron may be needed. IV loading dose followed by intermittent maintenance doses may be required.

The simple formula to see if a supplemental iron is required:

Transferrin saturation less than 25% *

Or/AndFerritin less than 100 g/dl

* some recommends 30%


References: click to get abstract/article if available

1. Diagnosis and management of iron-related anemias in critical illness. Critical Care Medicine. 34(7):1898-1905, July 2006
2. Optimization of Epoetin Therapy with Intravenous Iron Therapy in Hemodialysis Patients - Am Soc Nephrol 11:530-538, 2000