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Reference Library HomeErythrocyte Iron Incorporation but not Absorption is Increased by Intravenous Iron Administration in Erythropoietin-Treated Premature Infants
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Date Posted: Friday, July 7th, 2006
| Widness JA, Serfass RE, Haiden N, Nelson SE, Lombard KA, Pollak A, J Nutr, 2006 Jul;136(7):1868-73 |
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| Summary |
| In this study the authors report iron metabolism findings from their previously reported prospective randomized controlled open label trial investigating the effectiveness of intravenous (IV) iron (Fe) combined with erythropoietin (EPO) in stimulating erythropoiesis in premature infants (Pollak et al). Using tracer doses of Fe, the authors measured and compared Fe absorption and red blood cell (RBC) Fe incorporation in infants treated with oral Fe alone, EPO and oral Fe, and EPO, oral Fe plus IV Fe. Clinically stable very low birth weight premature infants initially received oral Fe supplementation for 3 days (run-in baseline period) and were then randomized to 3 groups: A control group (oral Fe only; n=9), an EPO group (EPO and oral Fe; n=10), and an IV Fe and EPO group (IV Fe + EPO; n=10). No subjects were allowed red blood cell (RBC) transfusions during the 18-day treatment period. During the treatment period, infants were administered isotopic nonradioactive oral and IV Fe preparations. Intestinal Fe absorption and RBC Fe incorporation was measured and compared in the 3 groups. Of interest, this study confirmed that preterm and term infants have a relatively high Fe absorption rate compared with older children and adults, and this despite high plasma ferritin concentrations. However, the investigators found no significant difference in Fe absorption rates between the 3 groups. The EPO group had a greater increase in hemoglobin (Hb) and reticulocyte count compared with the control group, but no difference in RBC Fe incorporation. Both the EPO group and the IV Fe + EPO groups had significantly increased plasma transferrin receptor concentrations compared with the controls. The IV Fe + EPO group had a greater increase in Hb and reticulocyte count, as well as plasma ferritin compared with the control group and the EPO group. The IV Fe + EPO group also had a greater RBC Fe incorporation. The authors report a 300-500% greater Fe incorporation in this group compared with those treated with EPO plus oral Fe or oral Fe alone. |
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