The goal of this clinical trial is to find out which method is better for guiding iron treatment in adult patients with end-stage kidney disease (ESKD) on hemodialysis who have anemia.
The main questions it aims to answer are:
Can using reticulocyte hemoglobin equivalent (RET-He) to guide intravenous (IV) iron treatment be as effective as using transferrin saturation (TSAT)?
Does the method used to guide iron treatment affect outcomes such as death, heart problems, hospitalizations, infections, or the need for blood transfusions?
Researchers will compare RET-He-guided iron treatment with TSAT-guided iron treatment to see if RET-He works just as well and has similar or better outcomes.
Participants will:
Receive IV iron based on either RET-He or TSAT levels
Have blood tests done at the start, 3 months, and 6 months
Have their doses of iron and erythropoietin (a medication to treat anemia) adjusted based on the assigned protocol
Be monitored for clinical outcomes such as hospitalization, heart events, and infections
Adult (age 18-80 years)
ESKD on chronic hemodialysis ≥ 6 months
EPO therapy ≥ 6 months
Hb < 13.0 g/dL in male, < 12.0 g/dL in female
Serum ferritin > 800 ng/mL or TSAT > 40%
Active infection or malignancy
Hematologic disease including thalassemia major, hemolysis, myelofibrosis or myelodysplastic disease
History of marrow suppressive or immunosuppressive medications in past 6 months
Map coordinates are unavailable for these locations. Locations are shown below instead.
ThailandKing Chulalongkorn Memorial Hospital
Lead sponsor
Sysmex Asia Pacific
Collaborator
Chulalongkorn University
Collaborator