Abstract: Objective To investigate the changes of hemoglobin(HB), inflammation and oxidative stress in hemodialysis patients before and after alternation from oral iron to intravenous iron. Methods Seventy-two dialysis patients, treated with enteral iron saccharate of 600mg daily and recombinant human erythropoietin (rHuEPO) of 100-150IU/w weekly with HB level lower than 100.0g/L for last two and a half years, were switched to intravenous iron therapy. Intravenous iron was first pumped at the dose of 100mg during each dialysis session to a total amount calculated by following formula: Iron amount = body weight (Kg)150-measured HB (g/L)] 0.24+500(mg) and then supplemented at the dose of 100mg bi-weekly. HB, transferrin saturation(TSAT), ferritin, interleukin-6 (IL-6), tumor necrosis factor (TNF ), C reactive protein(CRP), meleic dialdehyte malondialdehyde (MDA) were retrospectively analyzed at the beginning, the end of the first and the second year of each preparation for consecutive three months. One fourth of the dose of rHuEPO was reduced when HB level was above 130g/L. Results During the 2 years treated with oral iron, dose of rHuEPO administered was (9863 655) unit/week, HB was (95.60 9.74)g/L，TSAT was (15.30 2.45)%，no significance was found among initials, the end of the first and the second year of treatment (P ＞0.05), During the 2 years treated with intravenous iron, dose of rHuEPO decreased to (7416 437)unit/week, HB increased to (122.60 11.60) g/L, TSAT increased to (31.30 3.35)%, there were significant differences of these parameters between intravenous iron and oral iron therapy, at the end of the first and the second year of intravenous iron therapy and at the initial of intravenous iron therapy (P＜0.05), but no significant difference between those at the end of the first year and the end of the second year of intravenous iron therapy (P＞0.05). IL-6, TNF- and ferritin had no significant change during the whole observation, but MDA was increased from (7.83 4.85) ng/ml to (13.42 7.15) ng/ml in after intravenous iron therapy (P＜0.05). Conclusion In maintained hemodialysis patients, iron deficiency and anemia were improved, and peroxidation was aggregated but inflammation had no significant deterioration after alteration from oral iron to intravenous iron.

Key words: Iron, Hemoglobin, Inflammation state, Peroxidation