Impact of Inflammation on Ferritin, Hepcidin and the Management of Iron Deficiency Anemia in Chronic Kidney Disease

摘要: Iron deficiency anemia (IDA) is a major problem in chronic kidney disease (CKD), causing increased mortality. Ferritin stores iron, representing iron status. Hepcidin binds to ferroportin, thereby inhibiting absorption/efflux. Inflammation CKD increases ferritin and hepcidin independent of status, which reduce availability. While intravenous therapy (IIT) superior oral (OIT) patients with inflammation, OIT as effective IIT those without. reduces predictive values for status responsiveness therapy. Upper limit predict overload higher inflammation than However, magnetic resonance imaging studies show lower cutoff levels serum dialysis apparent upper proposed by international guidelines. Compared optimal IDA are without, requiring reduced dose leading decreased The management should differ between without include minimization inflammation. Further needed determine the impact on ferritin, therapeutic strategy CKD.