1. Resolving the paradigm crisis in intravenous iron and erythropoietin management 
A. Besarab 
Kidney International 
Volume 69, Pages S13-S18 (May 2006)
DOI: /sj.ki
Copyright © 2006 International Society of Nephrology Terms and Conditions

2. Figure 1
Trends in i.v. iron usage among US hemodialysis patients, 1994–2002. Although nearly 85% of all hemodialysis patients on EPO therapy received i.v. iron at least once during 2002, only 55% received i.v. iron at least monthly, indicating a failure to implement routine i.v. iron continued protocols as established by the K/DOQI guidelines.2
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3. Figure 2
Functional iron deficiency following the initiation of EPO therapy. The supraphysiologic rate of erythropoiesis with EPO results in a depleted pool of storage iron, as iron is moved into the erythroid marrow for incorporation into new red blood cells. Hgb, hemoglobin; HD, hemodialysis.
Adapted from Excerpta Medica International Congress Series No. 366, 1975, pp 190–98.6
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4. Figure 3
Graphic representation of intermittent repletion (solid bar) versus repletion followed by ongoing (dotted line) approaches to i.v. iron therapy. An intermittent repletion regimen results in a ‘rollercoastering’ effect on iron stores.
Reprinted with permission from Nephron 1999; 81: 362–363.8
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5. Figure 4
Change in mean Hgb levels with a continued low-dose regimen of sodium ferric gluconate versus an intermittent regimen. Reprinted with permission from Am J Nephrol 2002; 22: 67–72.17
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6. Figure 5
I.v. iron expenditures compared with reductions in EPO requirements with an aggressive i.v. iron continued regimen (100 mg/week via bolus). Although i.v. iron expenditures increased in this population of 116 hemodialysis patients by $38 500, the reduction in EPO dosages translated into a net cost savings of $362 000.
Adapted with permission from Am J Kidney Dis 1999; 34(Suppl 2): S40–S46.18
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7. Figure 6
Continued iron therapy and anemia management protocol used by the Henry Ford Health System. TSAT, transferrin saturation.
Kidney International  , S13-S18DOI: ( /sj.ki )
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