The Japanese Journal of Clinical Dialysis Vol.29 No.13(4-4)

Theme Problems to be solved in the therapy for renal anemia : Association of ESA hyporesponsiveness with dysregulated iron metabolism
Title Iron supplementation and usage of erythropoiesis stimulating agents for dialysis patients
Publish Date 2013/12
Author Akihiko Kato Blood Purification Unit, Hamamatsu University Hospital
[ Summary ] Intravenous iron infusion induces oxidative stress, vascular endothelial dysfunction, inflammation and immune dysfunction in vivo. There is also a possibility that overdoses of iron contribute to progression of arteriosclerosis, activation of chronic hepatitis C viral infection, poor responses to vaccination, and aggravation of bacterial infections. Therefore, it is necessary to administer iron carefully considering the pros and cons of iron treatment. It is also desirable to limit the number of iron infusions as much as possible to lessen iron-induced oxidative stress. Long-acting erythropoiesis stimulating agents and/or online hemodiafiltration treatment may reduce levels of serum hepcidin-25. We must establish safety protocols for iron administration to hemodialysis patients.
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