Comparison of administration of oral versus Infusions intravenous iron therapy in diabetic patients with chronic kidney disease receiving Erythropoietin

Abstract

Objective: To compare the efficacy of administration oral versus infusions intravenous iron (IV) therapy in diabetic patients with chronic kidney disease (CKD) receiving Erythropoietin.

Methodology: This retrospective comparative study, including 144 diabetic and CKD patients (72 in each group) was conducted at Northwest General Hospital, Peshawar, by reviewing patient records from January 2020 to December 2024. Patients with complete medical records were included consecutively. Group-A was given oral ferrous sulfate (200mg twice daily) for four weeks, whereas Group-B was given intravenous iron sucrose infusion once weekly for the same period. The efficacy was measured in-terms of iron deficiency anemia. The analysis was performed using IBM-SPSS-25. Due to the retrospective design, it inherits the bias of missing data, however exclusion criteria was strictly followed to minimize this bias.

Results: The baseline characteristics, including age, gender, ferritin levels, and CKD stage, were similar across both groups. After four weeks of iron therapy, 24(33.3%) of patients showed improvement in Group-A while 44(61.1%) of patients in Group-B (p=0.001). Sub-Group analyses revealed that Group-B patients show significantly higher improvement in males, older (56-70) years patients, and longer diabetes duration (p<0.001). Stage-5 CKD patients showed better outcomes with IV iron (p<0.001).

Conclusion: IV iron therapy was significantly more effective and show superior efficacy in older patients, males, and those with longer diabetes mellitus duration than oral therapy in improving anemia-related complications in diabetic patients with CKD receiving Erythropoietin, making it a preferable treatment choice in this population.