Iron Therapy to Reduce Cost and Increase Treatment Efficacy of Iron Deficiency Anemia: A Dialysis Center Experience

Background: Anemia in hemodialysis patients is very common. Main cause is iron deficiency Anemia. Erythropoietin deficiency is another main cause of Anemia. Maintaining sufficient iron stores while using lowest epoetin dose is a main therapy goal in Hemodialysis patients to avoid side effects of epoetin. Methods: It is an observational retrospective single center experience conducted in Hemodialysis patients. Patients reviewed in 2 interval periods. First from May-2024 to September-2024 and second period was from October-2024 to February-2025 after application of iron dosing protocol as proactive and reactive pattern according to laboratory results of Hemoglobin, ferritin and transferring saturation. The aim was to reduce epoetin use to reduce the cost by using iron therapy in the best up to date standards of care. Results: Hemoglobin level was maintained at the target level during all study periods. There was significant reduction in epoetin dose by 31.5% which resulted significantly in cost reduction with almost same amount of iron dose given in both interval periods, indicating that the way and methodology of giving iron is very important. There was important observation in safety end points monitoring which is reduction in incidence of impaired liver function events after reduction of epoetin dosing. Conclusion: Use of intravenous iron in a proactive pattern led to significant reduction in epoetin cost without concerns regarding side effects of intravenous iron. Funding: Government Support – Non-U.S.