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

• Type: Another Publication in an International Scientific Journal
• Date: 2016

Authors

Ribeiro, S (Author) Other; Belo, L (Author) FFUP; Reis, F (Author) Other; Santos Silva, A (Author) FFUP

Journal

Title: Blood Reviews

Vol. 30

Pages: 65-72

ISSN: 0268-960X

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 17 Citations

Scopus - 22 Citations

Other information

Authenticus ID: P-00G-V3V

DOI: 10.1016/j.blre.2015.07.006

Abstract (EN): 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.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8