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[Parenteral iron and folic acid in patients on chronic hemodialysis: requirements, monitoring, and effective use].

Iron and folic acid metabolism were prospectively studied over a 7 year period in 12 patients on chronic hemodialysis. Three protocols of iron and folic acid administration were successively used: in Phase A (mean 35.5 months) iron dextran intravenously was used at high dose (mean 416 mg monthly) with folic acid 1 mg/day; in Phase B (mean 8.1 months) iron and folic acid were not given, and in Phase C low dose iron dextran (mean of 10 mg monthly) and folic acid 3 mg per week were administered. No other medications, except for blood transfusion or Aluminum hydroxide were used throughout. A good correlation was found between serum ferritin levels and bone marrow iron stores. No side effects of iron administration were noted. A significant rise in Hb levels was observed (9.21 g/dl in Phase A to 10.3 g/dl in Phase C). Red cell protoporphyrin levels remained normal. With folic acid supplement of 3 mg per week, serum folate level remained within normal limits.