Iron Infusion Frequency Guidelines

Initial Treatment Course Recommendations

For hemodialysis patients with iron deficiency, the National Kidney Foundation recommends administering 100-125 mg IV iron weekly for 8-10 doses 1, 2
For non-dialysis CKD, home hemodialysis, and peritoneal dialysis patients, the National Kidney Foundation suggests a single infusion of 500-1000 mg may be administered and repeated as needed 1, 2
The American Journal of Kidney Diseases guidelines advise waiting at least 7 days between large doses (>200 mg) to allow for accurate assessment of iron parameters 1, 3

The National Kidney Foundation recommends that once optimal hemoglobin/hematocrit and iron stores are achieved, maintenance IV iron may vary from 25-125 mg/week for hemodialysis patients 1, 2
For non-dialysis patients, the European Society for Medical Oncology suggests repeat treatment when iron deficiency recurs, with frequency based on monitoring of iron parameters 4
The American Journal of Kidney Diseases guidelines recommend iron status during maintenance therapy should be monitored by measuring TSAT and serum ferritin every 3 months 2, 5

The National Kidney Foundation advises that for doses of 100-125 mg or less per week, iron parameters can be measured without interrupting therapy 2, 3
For doses of 200-500 mg, the American Journal of Kidney Diseases guidelines recommend waiting at least 7 days before measuring iron parameters 1, 6

The American Academy of Pediatrics recommends for hemodialysis patients: <10 kg: 25 mg per dose; 10-20 kg: 50 mg per dose; >20 kg: 100 mg per dose 5, 6
For predialysis and peritoneal dialysis patients, the American Academy of Pediatrics suggests <10 kg: 125 mg; 10-20 kg: 250 mg; >20 kg: 500 mg 5, 6

The National Kidney Foundation recommends withholding IV iron when TSAT >50% and/or serum ferritin >800 ng/mL for up to 3 months 1, 2
The American Journal of Kidney Diseases guidelines advise resuming at reduced dose (one-third to one-half) when levels fall below these thresholds 2, 3