| Theme |
Problems to be solved in the therapy for renal anemia : Association of ESA hyporesponsiveness with dysregulated iron metabolism |
| Title |
Better iron administration developed in large clinical trials |
| Author |
Takahiro Kuragano |
Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine |
| Author |
Takeshi Nakanishi |
Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine |
| [ Summary ] |
Recently in the US and European countries, the frequency of iron use has increased, while the dose of ESA (erythropoiesis-stimulating agents) has decreased. However, no prospective safety trials of intravenous iron administration have been adequately powered to examine adverse events, and survival rates. Recently published clinical trails, related to iron overload, hyporesponsiveness to ESA, and Hb variability have revealed that repleted iron storages were not necessarily to maintain target Hb levels. Furthermore, on-going clinical trials also showed that patients with repleted iron levels or high amplitude iron storage bear high risk of adverse events or death. Iron dysregulation should be taken into consideration when we prescribe iron preparations for chronic kidney disease patients. |