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Although the information is not new, this retrospective study in renal failure patients corroborates a growing body of data clarifying that low-molecular-weight iron dextran (LMW ID), as opposed to high-molecular-weight iron dextran (HMW ID, is as safe and efficacious as iron sucrose, ferric gluconate, and almost certainly any of the new iron preparations, ferumoxytol, ferric carboxymaltose and iron isomaltoside. It also points out how felicitous a total dose infusion of one gram of LMW ID is compared to multiple doses of the salts. It does not, as it cannot, since there are no comparison data, compare LMW ID to the newer compounds, all of which are capable of providing complete replacement dosing in 15 minutes. A recent presentation by Okum at the Brigham and Womens’ hospital in Boston and a manuscript by Auerbach et al. in the American Journal of Hematology corroborate this well-done piece of work.

– Michael Auerbach