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NDT Advance Access originally published online on June 7, 2007
Nephrology Dialysis Transplantation 2007 22(9):2429-2431; doi:10.1093/ndt/gfm287
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

A primer on iron therapy

Liliana Schaefer1 and Roland M. Schaefer2

1Institute of Pharmacology and Toxicology, University of Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt and 2Department of Medicine, University of Muenster, Albert-Schweitzer-Str 33, 48149 Muenster, Germany

Correspondence and offprint requests to: Roland M. Schaefer, MD, Department of Medicine, University of Muenster, Albert-Schweitzer-Str. 33, 48149 Muenster, Germany. Email: schaefe@uni-muenster.de

Keywords: Chronic kidney disease; renal anaemia; erythropoiesis-stimulating agents (ESA); intravenous iron therapy; anaphylactoid reactions

The first 10% of the full text of this article appears below.



   Introduction
 
Iron deficiency is a frequent complication in patients with chronic kidney disease (CKD). Major causes are reduced dietary intake, impaired absorption, chronic blood loss, inflammatory or infectious comorbidity and increased requirements during correction of renal anaemia with erythropoiesis-stimulating agents (ESA). Inadaequate iron stores with reduced availability of iron to the bone marrow are the main cause of hyporesponsiveness to ESA treatment. Thus, in the vast majority of haemodialysis patients, intravenous iron is used in combination with ESA to treat renal anaemia. Optimal iron management, therefore, includes the monitoring of iron status and the supplementation of adaequate amounts of iron, to maintain haemoglobin levels at target in a cost-effective manner [1].



   Monitoring iron status
 
Ferritin
Serum ferritin is a parameter of iron storage in the reticuloendothelial system. In subjects without kidney disease, a value below 15 ng/ml indicates absolute iron deficiency [. . . [Full Text of this Article]

Transferrin saturation (TSAT)
Hypochromic red cells
Content haemoglobin of the reticulocyte (CHr)


   Iron therapy
 
Iron requirements
Choice of intravenous iron preparations
Dosing of intravenous iron preparations


   Summary
 

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