Chronic kidney disease (ND-CKD), Iron deficiency and iron deficiency anaemia

Nephrology ND-CKD

Decreased kidney function in patients with chronic kidney disease may reduce the stimulation of red blood cell synthesis and the utilisation of nutritional or stored iron. This can lead to the development of anaemia even in patients who are not on haemodialysis.

The recently published Kidney Disease Guideline: Improving Global Outcomes Clinical Practice Guideline for Anaemia in Chronic Kidney Disease1 emphasises the importance of recognising and treating iron deficiency first in the treatment of anaemia.
The new Guideline highlights iron therapy as a cornerstone in the treatment of anaemia, emphasising the importance of recognising and treating iron deficiency in CKD patients. A key component is the recommendation to address all correctable causes of anaemia, including iron deficiency, before initiating treatment with erythropoiesis-stimulating agents (ESAs). Treatment with intravenous iron is noted as a way to treat iron deficiency anaemia, which can avoid or reduce the use of ESAs, avoid or minimise blood transfusions, and help treat anaemia-related conditions, potentially through enhancing erythropoiesis and raising haemoglobin levels1.

More details available on the KDIGO website.

References
1. Kidney Disease: Improving Global Outcomes (KDIGO) Anaemia Work Group. KDIGO Clinical Practice Guideline for Anaemia in Chronic Kidney Disease. Kidney Int Suppl 2012;2:279–335

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