Treating iron deficiency and iron deficiency anaemia in patients with CKD

In patients with CKD-associated iron deficiency anaemia, the aim of iron therapy is to ensure adequate iron stores for erythropoiesis, to correct iron deficiency, and, in patients receiving ESA treatment, to prevent iron deficiency from developing. Iron therapy, particularly with IV iron, can enhance erythropoiesis and raise haemoglobin levels in CKD patients with anaemia even when TSAT and ferritin levels do not indicate absolute iron deficiency1.

Recent guidelines for management of anaemia in CKD recommend regular testing for iron deficiency in both non-anaemic and anaemic patients, with the frequency of testing dependent on the stage of disease and treatment (Table 2)1. Reliance on haemoglobin level alone for diagnosis should be avoided, as this could potentially lead to delay in the identification and treatment of iron deficiency in CKD.

Table 2. Frequency of testing for anaemia in patients with chronic kidney disease1


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