Iron metabolism in the anaemia of chronic renal failure. Effects of dialysis and of parenteral iron.

Serial studies of iron transport in patients on maintenance dialysis showed normal or raised values in almost all subjects and a transient increase soon after the start of dialysis in three. These patients, who were seldom or never transfused, had low serum iron levels and normal iron-binding capacity with low saturation. Iron transport was substantially increased by parenteral iron-dextran treatment. Tracer studies showed good iron utilization, with transport to the marrow rather than to the liver. In these circumstances iron therapy is safe and beneficial, and a useful rise in red cell mass was shown to result from it. The packed cell volume was found to be a valid index of red cell mass in these patients. Red cell loss in the dialysers was insufficient to account for the observed reduction in red cell survival.