Evaluation and Treatment of Iron Deficiency in Patients with Kidney Disease

摘要: Iron deficiency is common in patients with kidney disease and one of the primary causes for decreased response to recombinant human erthropoietin (rHuEPO) therapy. Serum ferritin percent tranferrin saturation are regarded as preferred indirect measurements iron status. The National Kidney Foundation-Kidney Disease Outcome Quality Initiative (K/DOQI) guidelines recommend levels openface>100 ng/ml and>20%, respectively. These tests, however, have practical limitations lack sensitivity specificity identify “functional” deficiency, which can occur presence normal or even increased stores. Newer methods assessing status becoming available, reticulocyte hemoglobin content (CHr) showing most promise at this time. K/DOQ1 that adequacy should be based on amount needed sufficiently achieve target hematocrit 11–12 g/dL, 33–36%. Studies demonstrated a majority hemodialysis some predialysis peritoneal dialysis intravenous therapy necessary improve response, thus reducing rHuEPO these goals. Though generally safe effective, caution taken regard acceptable amounts supplementation long-term effects potential risk overload.