IS THERE ANY VALUE OF ORAL IRON IN HEMODIALYSIS PATIENTS RECEIVING rHuEPO?
Numerous studies have shown that the increased demand for iron driven by stimulated erythropoiesis in ESRD patients receiving rHuEPO, coupled with ongoing significant iron loss from a variety of sources in hemodialysis patients, make it difficult for traditional forms of oral iron to sufficiently meet the iron needs of this patient population8,9,10,11. Compounding the problem is the limited absorption of these forms of oral iron, and the poor patient tolerance, the latter primarily related to gastrointestinal side effects. Recent evidence suggests, however, that heme-iron polypeptide (HIP), a new generation of oral iron product, may overcome these limitations of traditional forms of oral iron and be effective as a form of iron replacement in this patient population12,13. HIP uses the heme porphyrin ring to supply iron to the key sites of intestinal absorption, which differ from those for non-heme iron. HIP is produced by hydrolysis of bovine hemoglobin using a technique that leaves pep
