The coadministration of intravenous iron dextran and heparin as a continuous infusion during hemodialysis (HD) is a safe and effective method used in maintaining and/or increasing iron stores and hematocrit levels in patients with end stage renal disease (ESRD). The technique of mixing iron dextran in low doses with heparin and infusing this mixture via the heparin syringe pump on the dialysis machine has shown to be cost effective, as well as instrumental in reducing the risk of adverse reactions due to rapid infusion or large dose infusion of iron dextran. At the Cleveland Clinic Foundation, we developed a protocol based on this methodology. A total of more than 1,000 doses of intravenous iron dextran and heparin have been administered to our HD patients using this technique, and no adverse reactions have been reported or observed.