Iron management during treatment with recombinant human erythropoietin in chronic renal failure.

The anemia of chronic renal failure often contributes to the poor functional status in patients with renal insufficiency and results primarily from decreased erythropoietin production. Recombinant human erythropoietin (rHuEpo) results in clinical and symptomatic improvements in patients with anemia of chronic renal failure. Treatment with rHuEpo also improves the quality of life in these patients. Resistance to rHuEpo therapy is not uncommon, however, and often is related to iron deficiency resulting from rapid erythropoiesis during rHuEpo therapy. Interestingly, rHuEpo-treated patients may continue to develop iron deficiency while receiving oral iron. Alternatively, parenteral iron is effective in replenishing iron stores and sustaining erythropoiesis in patients treated with rHuEpo.