目的 探讨异麦芽糖酐铁对腹膜透析(peritoneal dialysis，PD)患者合并绝对铁缺乏所致贫血的疗效及不同剂量对残余肾功能的影响。 方法 回顾性分析规律PD超过3个月、铁蛋白＜100μg/L且转铁蛋白饱和度＜20%的患者。根据单次静脉注射异麦芽糖酐铁剂量分为A组(500 mg)和B组(1000 mg)，比较2组再治疗时间、血红蛋白、铁代谢指标及残肾功能变化。 结果 共纳入34例患者，2组各17例。静脉铁治疗后，患者铁蛋白(t=-6.675，P＜0.001)、转铁蛋白饱和度(t=-5.244，P＜0.001)、血红蛋白(t=-3.986，P＜0.001)升高。A组和B组再次治疗时间分别为(3.41±1.33)个月和(5.31±2.56)个月，A组短于B组(t=-2.771，P=0.009)；A组末次铁蛋白水平低于B组(t=-2.225， P=0.033)。B组患者异麦芽糖酐铁治疗后残余肾Kt/V由0.35下降至0.23(Z=-2.556，P=0.011)，A组治疗前后差异无统计学意义(Z=-1.183，P=0.237)。 结论 异麦芽糖酐铁可有效改善PD合并绝对铁缺乏患者的铁代谢状态并提升血红蛋白水平。500 mg与1000 mg静脉铁在改善贫血方面效果相当，但1000 mg静脉铁可能与铁蛋白快速升高及残余肾功能下降有关，应权衡使用。

Objective  To investigate the efficacy of iron isomaltoside in peritoneal dialysis (PD) patients with anemia caused by absolute iron deficiency and the effects of different doses on residual kidney function.  Methods  A retrospective analysis was conducted on patients who had undergone regular PD for more than 3 months, with ferritin ＜100 μg/L and transferrin saturation ＜20%. According to the dose of a single intravenous injection of iron isomaltoside, the patients were divided into group A (500 mg) and group B (1000 mg). The retreatment time, hemoglobin, iron metabolism indicators, and changes in residual kidney function were compared between the two groups.   Results  A total of 34 patients were included, with 17 patients in each group. After intravenous iron therapy, ferritin (t=-6.675, P＜0.001), transferrin saturation (t=-5.244, P＜0.001), and hemoglobin (t=-3.986, P＜0.001) increased. The retreatment time in group A and group B was (3.41±1.33) months and (5.31±2.56) months, respectively, with group A being shorter than group B (t=-2.771, P=0.009); the last ferritin level in group A was lower than that in group B (t=-2.225, P=0.033). In group B, residual kidney Kt/V decreased from 0.35 to 0.23 after iron isomaltoside treatment (Z=-2.556, P=0.011), while there was no statistically significant difference in group A before and after treatment (Z=-1.183, P=0.237).  Conclusion Iron isomaltoside can effectively improve iron metabolism status and increase hemoglobin levels in PD patients with absolute iron deficiency. Intravenous iron at 500 mg and 1000 mg has comparable efficacy in improving anemia, but 1000 mg intravenous iron may be associated with a rapid increase in ferritin and a decline in residual kidney function, and should be used with caution.