Management of chronic kidney disease and iron deficiency | T&F

Patients with CKD tend to be in a positive iron balance.

The initial work-up for anaemic patients with CKD is generally the same for CKD patients as in the general population.

CKD patients tend to have higher ferritin levels than the general population.

In absolute iron deficiency, total body iron stores are adequate but there is insufficient iron available for incorporation into red blood cells.

Hepcidin promotes the release of iron from reticuloendothelial macrophages and hepatocytes into plasma.

Bone marrow biopsy is commonly performed for the assessment of iron deficiency in patients with CKD.

Because oral iron is inexpensive and does not require intravenous access, it is the initial choice in most patients with CKD not on dialysis.

The laboratory criteria used to define iron deficiency in CKD patients are the same as those used patients with normal kidney function.

Pre-treatment with corticosteroids and/or antihistamines is recommended in patients identified as being at potential risk of a hypersensitivity reaction to intravenous iron.

Iron dextran is associated with a higher incidence of adverse effects, particularly anaphylaxis, than other intravenous preparations.