| [ Summary ] |
Iron deficiency is the major cause of erythropoiesis inhibition in dialysis patients receiving erythropoietin treatment. In 2004 the Japanese Society for Dialysis Therapy Guidelines for renal anemia, dialysis patients are considered to have an iron deficiency if transferrin saturation and serum ferritin levels are < 20 % and < 100 ng / ml respectively. Since intravenous iron therapy may aggravate tissue oxidation, infection risk and chronic viral hepatitis, and may have a link to atherosclerosis, excess iron, especially in complicated dialysis patients should be avoided. Hepcidin inhibits dietary iron absorption, the efflux of recycled iron from macrophages, and the release of iron from storage in hepatocytes. The role of hepcidin abnormalities in anemia associated with chronic renal disease and in resistance to erythropoietic therapies remains to be determined. |