Iron Indices and Intravenous Ferumoxytol: Time to Steady-State

Anemia is prevalent in patients withstage V chronic kidney disease (CKD) undergoing hemodialysis (HD) because of the deficiency of endogenous erythropoietin. In HD patients treated with an erythropoiesis-stimulating agent (ESA), relative iron deficiency is the most common cause of anemia.1-3 It of-ten results from blood loss during the dialysis process, frequent blood sam-pling, as well as increased demand for iron during exposure to an ESA. The on-going nature of iron loss in these patients makes it extremely difficult, without ad-equate supplementation, to maintain ade-quate iron concentrations.1,3-5 The Na-tional Kidney Foundation Kidney Dis-ease Outcomes Quality Initiative (NKF KDOQI) guidelines suggest administra-tion of iron to maintain transferrin satu-ration (TSAT) of at least 20 % and serum ferritin of at least 200 ng/mL.2 Because of the magnitude of iron loss, HD pa-tients with anemia frequently require in-travenous iron preparations, which re-sults in substantial increases in TSAT, ferritin, and hemoglobin (Hb).1-4,6-8 Until recently, there were 3 formula-tions of intravenous iron available in th