Journal article
Iron Deficiency in Chronic Kidney Disease: Updates on Pathophysiology, Diagnosis, and Treatment
Journal of the American Society of Nephrology, Vol.31(3), pp.456-468
03/2020
DOI: 10.1681/ASN.2019020213
PMCID: PMC7062209
PMID: 32041774
Abstract
Anemia is a complication that affects a majority of individuals with advanced CKD. Although relative deficiency of erythropoietin production is the major driver of anemia in CKD, iron deficiency stands out among the mechanisms contributing to the impaired erythropoiesis in the setting of reduced kidney function. Iron deficiency plays a significant role in anemia in CKD. This may be due to a true paucity of iron stores (absolute iron deficiency) or a relative (functional) deficiency which prevents the use of available iron stores. Several risk factors contribute to absolute and functional iron deficiency in CKD, including blood losses, impaired iron absorption, and chronic inflammation. The traditional biomarkers used for the diagnosis of iron-deficiency anemia (IDA) in patients with CKD have limitations, leading to persistent challenges in the detection and monitoring of IDA in these patients. Here, we review the pathophysiology and available diagnostic tests for IDA in CKD, we discuss the literature that has informed the current practice guidelines for the treatment of IDA in CKD, and we summarize the available oral and intravenous (IV) iron formulations for the treatment of IDA in CKD. Two important issues are addressed, including the potential risks of a more liberal approach to iron supplementation as well as the potential risks and benefits of IV versus oral iron supplementation in patients with CKD.
Details
- Title: Subtitle
- Iron Deficiency in Chronic Kidney Disease: Updates on Pathophysiology, Diagnosis, and Treatment
- Creators
- Elizabeth Katherine Batchelor - Department of Internal Medicine and.Pinelopi Kapitsinou - Renal Research InstitutePablo E Pergola - The University of Texas Health Science Center at San AntonioCsaba P Kovesdy - University of Tennessee Health Science CenterDiana I Jalal - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Journal of the American Society of Nephrology, Vol.31(3), pp.456-468
- DOI
- 10.1681/ASN.2019020213
- PMID
- 32041774
- PMCID
- PMC7062209
- ISSN
- 1046-6673
- eISSN
- 1533-3450
- Grant note
- R01 DK115850 / NIDDK NIH HHS R01 HL134738 / NHLBI NIH HHS
- Language
- English
- Date published
- 03/2020
- Academic Unit
- Nephrology; Internal Medicine
- Record Identifier
- 9984359901402771
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