| Theme |
Erythropoietin Up-To-Date |
| Title |
Renal anemia drugs: iron supplementation |
| Author |
Akihiko Kato |
Division of Nephrology, Endocrinology and Metabolism, Shizuoka Cancer Center Hospital |
| [ Summary ] |
Regular iron supplementation is often needed for hemodialysis (HD) patients treated with recombinant human erythropoietin (rHuEPO). Iron supplementation with every HD unit is effective in restoring HD patients with obvious iron deficiencies. In contrast, weekly intermittent iron injections may be safe and avoid iron-induced adverse effects such as infection and oxidative stress in patients with serum ferritin levels over 100ng/ml. It remains undetermined as to which hematopoietic parameters can be used to diagnose functional iron deficiency with greatest sensitively. Since the optimal use of iron for renal anemia is unknown in HD patients, physicians should pay attention to avoid iron overload (ferritin levels over 500ng/ml). Establishment of clinical guidelines for the management of functional iron deficiency is needed for Japanese HD subjects receiving rHuEPO treatment. |