Iron therapy in chronic kidney disease: Recent changes, benefits and risks

Blood Reviews
Sandra RibeiroAlice Santos-Silva

Abstract

Anemia is a common complication in patients with chronic kidney disease (CKD), mainly due to inadequate renal production of erythropoietin. In hemodialysis (HD) patients this condition may be aggravated by iron deficiency (absolute or functional). The correction of this anemia is usually achieved by treatment with erythropoiesis stimulating agents (ESAs) and iron (oral or intravenous). Studies questioning the safety of ESAs (especially at higher doses) changed the pattern of anemia treatment in CKD patients. According to the new guidelines, when transferrin saturation is lower than 30% and ferritin lower than 500 ng/mL, a trial with iron should be started, to avoid therapy with ESAs or at least to reduce the doses needed to treat the anemia. Recent reports showed increasing ferritin levels, towards values above 800 ng/mL, in CKD patients treated according to the guidelines. In this review we focus on the risks of the increased iron use to treat CKD anemia, namely, iron overload and toxicity, increased risk of infections, as well as mortality.

References

May 1, 2001·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·J StovesC G Newstead
Oct 31, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·David TovbinNaomi Meyerstein
Mar 14, 2003·Free Radical Biology & Medicine·Ren MinqinBarry Halliwell
Jul 16, 2003·Annals of Internal Medicine·Andrew S LeveyUNKNOWN National Kidney Foundation
Apr 20, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Geoffrey S TeehanBertrand L Jaber
May 22, 2004·Journal of the American Society of Nephrology : JASN·Harold I FeldmanGerald Faich
Apr 13, 2005·Nephron. Clinical Practice·Chaim CharytanUNKNOWN Venofer Clinical Studies Group
May 7, 2005·International Heart Journal·Kadriye Altok ReisSukru Sindel
Jul 22, 2005·Journal of the American Society of Nephrology : JASN·Kamyar Kalantar-ZadehDavid G Warnock
Dec 1, 2005·Kidney International·David B Van WyckUNKNOWN United States Iron Sucrose (Venofer) Clinical Trials Group
Sep 5, 2006·Seminars in Nephrology·Masaomi Nangaku, Kai-Uwe Eckardt
Oct 25, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Evangelia DounousiDimitrios Tsakiris
Nov 17, 2006·The New England Journal of Medicine·Tilman B DrüekeUNKNOWN CREATE Investigators
Nov 17, 2006·The New England Journal of Medicine·Ajay K SinghUNKNOWN CHOIR Investigators
Dec 15, 2006·Journal of the American Society of Nephrology : JASN·Sudhir V ShahVivian A Fonseca
Jul 1, 2008·American Journal of Nephrology·Elísio CostaAlice Santos-Silva
Nov 7, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Fredric O FinkelsteinSalim Mujais
Sep 4, 2009·Journal of Human Hypertension·M P C KaoA D Struthers
Sep 30, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Paolo FerrariJohn K Olynyk
Oct 12, 2010·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Wajeh Y QunibiSimon D Roger
Jan 14, 2011·Biometals : an International Journal on the Role of Metal Ions in Biology, Biochemistry, and Medicine·Amy Barton PaiPaul Hicks
Nov 2, 2011·Advances in Nutrition·An-Sheng Zhang
Dec 14, 2011·Hematology·Karin E Finberg
Sep 4, 2012·Free Radical Biology & Medicine·Reshmi RajendranFrank Watt
Sep 25, 2012·The American Journal of Medicine·Guy RostokerYves Cohen
Sep 26, 2012·American Journal of Nephrology·Sandra RibeiroAlice Santos-Silva
Mar 29, 2013·PloS One·Gloria Cuevas PrezaElizabeta Nemeth
Jun 22, 2013·Journal of the American Society of Nephrology : JASN·M Alan BrookhartAbhijit V Kshirsagar

❮ Previous
Next ❯

Citations

Mar 31, 2016·Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals·Pedro de Sousa-MartinsElísio Costa
Jul 30, 2016·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Ranganathan SrinivasanPrabal K Manna
Nov 13, 2015·Expert Review of Gastroenterology & Hepatology·Pierre Brissot
Feb 1, 2018·International Journal of Molecular Sciences·Joshua M KaplanSean Dikdan
Apr 6, 2018·Nature Reviews. Disease Primers·Pierre BrissotOlivier Loréal
Jun 18, 2018·Clinical and Experimental Medicine·Daijun XiangChengbin Wang
Jul 6, 2021·Frontiers in Medicine·Zhong ZhongHaiping Mao

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.

Related Papers

The Journal of the Royal College of Physicians of Edinburgh
A M Hazara, S Bhandari
Journal of the Royal College of Physicians of London
M Barry
Deutsche medizinische Wochenschrift
C MAIER
The Practitioner
A BROWN
Canadian Medical Association Journal
H C READ
© 2021 Meta ULC. All rights reserved