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The majority of end-stage renal patients undergoing maintenance hemodialysis (HD) develop anemia that adversely affects their quality of life and increases the risk for cardiovascular events and death. Thus, the development of safe and effective strategies aimed at correcting anemia in these patients is of utmost importance.1 Unfortunately, the response to erythropoietin (EPO) treatment is often suboptimal, due mainly to an imbalance between the surging iron requirements of the stimulated erythropoietic cells on the one hand and iron availability on the other. Thus, intravenous (i.v.) administration of iron-containing preparations is widely used in order to circumvent this imbalance. However, questions about the efficacy and the safety of this loading strategy still remain unanswered.1

Rapid elevation of transferrin saturation and serum hepcidin concentration in hemodialysis patients after intravenous iron infusion