BACKGROUND/AIM: Management of renal anemia in end-stage renal disease requires careful evaluation of the iron status before and in particular during erythropoietin treatment. However, there is no simple and practical iron index accurately predictive of functional iron deficiency in these patients till now. The purpose of this prospective study, therefore, is to evaluate whether a short course of low-dose intravenous iron challenge can detect functional iron deficiency in hemodialysis patients. METHODS: Twenty-four patients with baseline serum ferritin levels between 100 and 500 ng/ml were treated with intravenous saccharated ferric oxide, 960 mg over 24 hemodialysis treatments, and the hemoglobin level was checked every week. RESULTS: Patients whose hemoglobin value increased at least by 1 g/dl within the 8-week period were classified as having functional iron deficiency or as responders (n = 26; 81.2%). All other subjects were classified as having adequate iron levels or as nonresponders (n = 6; 18.8%). There were no significant differences in age, sex, dialysis years, Kt/V, dialyzers, hemoglobin, and basal and final transferrin saturation and ferritin between responders and nonresponders. In addition, there were no iron indices with acceptable levels of sensitivity and specificity. On the contrary, the cutoff value of increments of hemoglobin of at least 0.2 g/dl after a 2-week intravenous iron trial had a sensitivity of 96.2% and a specificity of 100% in all patients (n = 32) and a sensitivity of 100% and a specificity of 100% after patients with transferrin saturation <20% were excluded (n = 24). These values had the greatest utility of the tests studied in this work. CONCLUSION: A 240-mg intravenous iron challenge during a 2-week period may be a simple, accurate, and straightforward method to detect a functional iron deficiency status in hemodialysis patients undergoing erythropoietin therapy.

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PubMedDate not supplied

Effect of food-simulating liquids on the flexural strength of composite and polyacid-modified composite restoratives.

This study investigates the effects of food-simulating liquids on composite and polyacid-modified composite restoratives. Three composite (Z100, Spectrum TPH, and Tetric Ceram) and three polyacid-modified composite (F2000, Dyract AP, and Compoglass) restoratives from the same manufacturers were selected for the study. Flexural strength specimens (25 x 2 x 2 mm) based on ISO 4049 specifications were fabricated according to the manufacturers recommendations. After light polymerization, the specimens were removed from their molds and conditioned for one week at 37 degrees C in the following mediums: (1) deionized water, (2) 0.02 M citric acid, (3) heptane, and (4) 50% ethanol-water solution. Specimens stored in air were used as controls. The sample size was five for each material-medium combination. After conditioning, the specimens were blotted dry, measured, and subjected to flexural strength testing using an Instron Universal Testing Machine with a crosshead speed of 0.05 mm/minute. With the exception of Compoglass, flexural strength of all restoratives after conditioning in heptane was significantly greater than that after conditioning in all other mediums and the control. Although no significant difference in flexural strength values was observed between the different restoratives when the materials were conditioned in heptane or air (control), significant differences were observed between the different restoratives after conditioning in aqueous solutions (water, citric acid, and ethanol-water solution). The flexural strengths of the composites were generally significantly higher than their polyacid-modified counterparts after conditioning in the various aqueous solutions. The detrimental effects of aqueous solutions on flexural strength appeared to be greater with polyacid-modified composite resins than with composite restoratives.

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