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Few data exist to guide treatment of anemic hemodialysis patients with high ferritin and low transferrin saturation (TSAT). The Dialysis Patients’ Response to IV Iron with Elevated Ferritin (DRIVE) trial was designed to evaluate the efficacy of intravenous ferric gluconate in such patients. Inclusion criteria were hemoglobin≤ 11 g/dl, ferritin 500 to 1200 ng/ml, TSAT≤ 25%, and epoetin dosage≥ 225 IU/kg per wk or≥ 22,500 IU/wk. Patients with known infections or recent significant blood loss were excluded. Participants (n= 134) were randomly assigned to no iron (control) or to ferric gluconate 125 mg intravenously with eight consecutive hemodialysis sessions (intravenous iron). At randomization, epoetin was increased 25% in both groups; further dosage changes were prohibited. At 6 wk, hemoglobin increased significantly more (P= 0.028) in the intravenous iron group (1.6±1.3 g/dl) than in the control group (1.1±1.4 …