Iron Deficiency Anemia in Chronic Kidney Disease
| Autor: | Amir Schechter, Anat Gafter-Gvili, Benaya Rozen-Zvi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Anemia Iron medicine.medical_treatment urologic and male genital diseases Gastroenterology Peritoneal dialysis Renal Dialysis Hepcidin Internal medicine medicine Humans Renal Insufficiency Chronic Dialysis Clinical Trials as Topic Anemia Iron-Deficiency biology business.industry Transferrin saturation Hematology General Medicine Iron deficiency medicine.disease female genital diseases and pregnancy complications Iron-deficiency anemia Ferritins Quality of Life biology.protein business Kidney disease |
| Zdroj: | Acta Haematologica. 142:44-50 |
| ISSN: | 1421-9662 0001-5792 |
| DOI: | 10.1159/000496492 |
| Popis: | Iron deficiency anemia is a common complication of chronic kidney disease (CKD). CKD patients suffer from both absolute and functional iron deficiency. Absolute iron deficiency is defined by severely reduced or absent iron stores, while functional iron deficiency is defined by adequate iron stores but insufficient iron availability for incorporation into erythroid precursors. This is due to increased levels of hepcidin. Anemia in CKD is associated with an increased risk of morbidity and mortality. The association between anemia and mortality may be related to the severity of anemia. All CKD patients should be screened for anemia during the initial evaluation for CKD. Criteria used to define iron deficiency are different among CKD compared to normal renal function. Among CKD patients, absolute iron deficiency is defined when the transferrin saturation (TSAT) is ≤20% and the serum ferritin concentration is ≤100 ng/mL among predialysis and peritoneal dialysis patients or ≤200 ng/mL among hemodialysis patients. Functional iron deficiency, also known as iron-restricted erythropoiesis, is characterized by TSAT ≤20% and elevated ferritin levels. Iron supplementation is recommended for all CKD patients with anemia. There is general agreement according to guidelines that intravenous (i.v.) iron supplementation is the preferred method for CKD patients on dialysis (CKD stage 5D) and either i.v. or oral iron is recommended for patients with CKD ND (CKD stages 3–5). In this review we discuss the evidence base for these recommendations. |
| Databáze: | OpenAIRE |
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