Comparison of Oral Versus Intravenous Iron Therapy for The Treatment of Anemia in Patients with End-Stage Renal Disease. An Interventional Study at a Tertiary Care Setting, Nowshera

Abstract

Objective: Our research seeks to compare the efficacy and safety of 'oral' versus 'intravenous' iron therapy in treating anemia in patients suffering from end-stage renal disease (ESRD), with a focus on hemoglobin response and adverse effects profile.
Study Design: An interventional study.
Place and Duration of Study: This study was conducted at the Department of Nephrology, Pak Emirates Military Hospital (PEMH), Rawalpindi, Pakistan, and the Department of Medicine and Otorhinolaryngology (ENT), Combined Military Hospitals (CMH), Nowshera, Pakistan, from September 2024 to September 2025.
Methods: The study included 163 patients with end-stage renal disease (ESRD) and anemia, who received either oral iron (N=69) or intravenous iron (N=94) therapy. Group 1 received oral ferrous sulfate 200 mg elemental iron daily for 8 weeks, while Group 2 received intravenous iron sucrose 200 mg weekly for 5 weeks, totaling 1 g. Hemoglobin levels, iron stores, adverse reactions, and treatment costs were monitored over 6 weeks of therapy.
Results: Weekly intravenous iron therapy showed significantly greater increase in hemoglobin levels (2.87±1.11g/dL vs 1.60±1.26g/dL, P<0.001) and ferritin levels (254 ± 32ng/mL vs 112 ± 18ng/mL, P<0.001) compared to oral iron therapy in anemic patients of ESRD receiving hemodialysis. Gastrointestinal adverse effects were more common with oral iron (28% vs 8%; P=0.01). Hypersensitivity from systemic iron supplementation resulted in 10.52% (N=10) of patients.
Conclusion: Oral iron repletion was cost-effective and safe, yet intravenous iron therapy was more effective and better tolerated than oral iron therapy in treating anemia in ESRD patients. Making it the preferred treatment option. Individualization of therapy must be based on patients' needs and resources.

How to cite this: Sulman M, Sheikh NA, Ali U, Ahmed MT, Anwar A, Nadeem J. Comparison of Oral Versus Intravenous Iron Therapy for The Treatment of Anemia in Patients with End-Stage Renal Disease. An Interventional Study at a Tertiary Care Setting, Nowshera. Life
and Science. 2026; 7(3): 366-372. doi: http://doi.org/10.37185/LnS.1.1.1150