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Nephrology Dialysis Transplantation 2007 22(Supplement 3):iii2-iii6; doi:10.1093/ndt/gfm014
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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

OPTA-therapy with iron and erythropoiesis-stimulating agents in chronic kidney disease

W. H. Hörl1, I. C. Macdougall2, J. Rossert3 and R. M. Schaefer4

1Klinische Abteilung für Nephrologie und Dialyse, Medizinische Universitätsklinik III, Währinger Gürtel 18–20, 1090 Wien, Austria, 2King's College Hospital, London, UK, 3Paris-Descartes University School of Medicine, AP-HP, Georges Pompidou European Hospital, Paris, France and 4Universitätsklinikum Münster (UKM), Innere Medizin D, Albert-Schweitzer-Straße 33, 48149 Münster, Germany

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   Introduction
 
Anaemia is a severe problem for patients suffering from chronic kidney disease (CKD). Anaemia is occasionally observed among patients with glomerular filtration rate (GFR) of 30–60 ml/min (stage III of CKD). Majority of the patients with GFR <30 ml/min exhibit renal anaemia. Diabetic patients may develop anaemia earlier than those with non-diabetic CKD (e.g. GFR of <45 ml/min). The European Best Practice Guidelines for the Management of Anaemia in Patients with Chronic Renal Failure [1] recommend therapy with erythropoiesis stimulating agents (ESA) for patients in whom the haemoglobin concentration is <11 g/dl and additional causes for anaemia, such as iron deficiency, bleeding or malignancy are excluded. Early treatment of anaemia is recommended, since reduced haemoglobin values are associated with left ventricular hypertrophy, increases in morbidity and mortality, increases in the frequency and duration of hospitalization and reduction in quality of life. An adequate measurement of iron status at . . . [Full Text of this Article]



   Monitoring of iron status
 
Ferritin
Transferrin saturation
Evaluation of iron supply in the bone marrow—percentage of hypochromic red blood cells
Haemoglobin content of reticulocytes (CHr)
Practical considerations


   Iron therapy
 
Iron requirements
Iron preparations for intravenous administration
Dosage and frequency of administration
Iron requirements of pre-dialysis patients, peritoneal dialysis patients and renal transplant patients
Guidelines for intravenous iron injection
Importance of intravenous iron therapy


   Summary
 

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