From the Guidelines
Optimal levels for iron studies should be maintained at a transferrin saturation (TSAT) of 20% and serum ferritin of 100 ng/mL in all patients, as recommended by the NKF-K/DOQI clinical practice guidelines 1. To achieve these levels, iron therapy should be tailored to individual patient needs, taking into account factors such as hemoglobin (Hct) levels and Epoetin doses.
- Key considerations for iron therapy include:
- TSAT and serum ferritin levels should be monitored at least every 3 months to optimize erythropoiesis in hemodialysis patients 1.
- Additional iron should be given to patients with TSAT 20% and/or serum ferritin 100 ng/mL when Hct is 33% and/or Epoetin doses are greater than anticipated, as long as administration of such iron does not chronically maintain the TSAT at 50% or serum ferritin at 800 ng/mL 1.
- The goal of iron therapy is to improve erythropoiesis, not to attain specific levels of TSAT and/or serum ferritin 1.
- Iron overload can be avoided by temporarily withholding IV iron administration if TSAT or ferritin levels temporarily become too high 1. By following these guidelines and monitoring iron studies regularly, healthcare providers can help ensure optimal iron balance and minimize the risk of iron deficiency or overload in patients.
From the FDA Drug Label
Eligibility criteria for Venofer treatment included patients undergoing chronic hemodialysis, receiving erythropoietin, hemoglobin level between 8. 0 and 11. 0 g/dL, transferrin saturation <20%, and serum ferritin <300 ng/mL.
The optimal levels for iron studies are:
- Hemoglobin: between 8.0 and 11.0 g/dL
- Transferrin saturation: <20%
- Serum ferritin: <300 ng/mL 2