The Japanese Journal of Clinical Dialysis Vol.17 No.12(7)

Theme Expanding Clinical Experimental Findings for Nutritional Management
Title Iron deficiency and nutrition
Publish Date 2001/11
Author Hiroko Okano Department of Medicine IV, Tokyo Women's Medical University
Author Ken Tsuchiya Department of Medicine IV, Tokyo Women's Medical University
[ Summary ] In general, dialysis patients tend to be iron deficient because of potential dietary limitations and erythropoiesis, stimulated by recombinant human erythropoietin (rHuEPO) treatment. The diet for dialysis patients should contain 8 to 10mg/day of iron, which amount is less than the normal amount of iron. Several factors, such as vitamin C deficiency, due to the potassium restriction and administration of anti-ulcergenic agents, prevent effective absorption of iron in the intestinal tract, resulting in the acceleration of iron deficiency. Moreover, external administration of rHuEPO may induce functional iron deficiency. So, the evaluation of accurate iron status in dialysis patients provides critical information for adequate iron and rHuEPO treatment. Recently, new markers of iron status, such as hemoglobin content of reticulocyte and serum soluble transferrin receptors, have been available as reliable measures of iron status on an erythrocytopoietic basis along with conventional iron parameters, serum ferritin levels, transferrin saturation, etc. It is necessary to closely monitor iron status with precise markers and to induce parenteral iron administration adequate dosage for rHuEPO treatment.
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