Minor impairment of oral iron absorption in non-diabetic new dialysis patients

David Tovbin, Alla Schnaider, Marina Vorobiov, Boris Rogachev, Anna Basok, Philip Shull, Victor Novack, Michael Friger, Dan Avramov, Moshe Zlotnik

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Iron absorption is impaired in end-stage renal disease (ESRD). ESRD duration and diabetes mellitus (DM) are prominent risk factors in ESRD patients, associated with multi-system complications involving the gastrointestinal tract. Therefore, we suggest that DM and ESRD duration contribute to iron absorption impairment in ESRD. Since we administer oral iron during hemodialysis (HD) sessions, we assessed the relationship of DM and ESRD duration to intradialytic iron absorption. Methods: A 4-hr intradialytic oral iron absorption test was performed in 22 non-diabetic patients and 21 diabetic chronic HD patients. Elemental iron, 100 mg (iron(III)-hydroxide-polymaltose) was administered at dialysis start. Serum iron levels were measured hourly since iron ingestion, and standardized according to transferrin levels to correct for intradialytic blood volume changes. The primary end point was peak increase in standardized serum iron level (ΔI). ESRD duration and DM were defined as months on dialysis and the presence of DM before dialysis initiation, respectively. Evaluated confounding factors included age, gender, dry weight (DW), ultrafiltration volume (UF), UF /DW, eKt/V, transferrin saturation (%SAT), ferritin, parathyroid hormone (PTH), C-reactive protein (CRP) and erythropoietin (EPO) dosage. Results: ΔI was significantly inversely correlated with ESRD duration. DM was significantly associated with lower ΔI after statistically controlling for ESRD duration. These relationships remained significant after statistically controlling for %SAT, UF and UF/DW. %SAT was significantly inversely correlated with ΔI, but contributed to lower variability of ΔI (11%) than DM (15.2%) and ESRD duration (16.5%). Conclusions: Intradialytic iron absorption was less impaired in non-diabteic patients with shorter ESRD duration. Therefore, intradialytic oral iron therapy could be successful in these patients.

Original languageEnglish
Pages (from-to)174-180
Number of pages7
JournalJournal of Nephrology
Issue number2
StatePublished - 1 Mar 2005


  • Absorption
  • Anemia
  • Diabetes mellitus
  • End-stage renal disease duration
  • Hemodialysis
  • Intradialytic
  • Intradialytic iron absorption
  • Iron
  • Iron absorption
  • Oral iron

ASJC Scopus subject areas

  • Nephrology


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