Issues related to iron replacement in chronic kidney disease

Rajiv Agarwal, David Warnock

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Recent epidemiologic studies show that iron deficiency occurs in the vast majority of patients with chronic kidney disease (CKD). In patients with CKD, increased iron losses and, to a lesser extent, poor oral absorption, can lead to iron-deficiency anemia. Correction of iron-deficiency anemia is preferable by the oral route, however, data on oral iron use are limited in this population. In CKD patients, parenteral iron administered with recombinant human erythropoietin (rHuEpo), is the best potential option for the correction of anemia. Nondextran iron preparations are preferable because of a reduced incidence of serious adverse events. Parenteral iron in CKD patients may not be entirely innocuous and, although commonly used, have not received Food and Drug Administration approval for use in this patient population. Exposure to intravenous (IV) iron may lead to oxidative stress, renal injury, infection, cardiovascular disease, and osteomalacia. Studies are needed to confirm the existence and magnitude of these complications. The current data suggest that the overall risk-benefit ratio favors use of IV iron when compared with untreated or partially treated iron-deficiency anemia.

Original languageEnglish
Pages (from-to)479-487
Number of pages9
JournalSeminars in Nephrology
Volume22
Issue number6
StatePublished - Nov 2002

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Chronic Renal Insufficiency
Iron
Iron-Deficiency Anemias
Drug Approval
Osteomalacia
United States Food and Drug Administration
Erythropoietin
Population
Anemia
Epidemiologic Studies
Oxidative Stress
Cardiovascular Diseases
Odds Ratio
Kidney
Incidence
Wounds and Injuries
Infection

ASJC Scopus subject areas

  • Nephrology

Cite this

Issues related to iron replacement in chronic kidney disease. / Agarwal, Rajiv; Warnock, David.

In: Seminars in Nephrology, Vol. 22, No. 6, 11.2002, p. 479-487.

Research output: Contribution to journalArticle

Agarwal, Rajiv ; Warnock, David. / Issues related to iron replacement in chronic kidney disease. In: Seminars in Nephrology. 2002 ; Vol. 22, No. 6. pp. 479-487.
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