The Japanese Journal of Clinical Dialysis Vol.33 No.2(4-2)

Theme Guideline for CKD-related anemia -- looking back twice's revision
Title Questioning iron replacement treatments for dialysis patients prior to ESA therapy
Publish Date 2017/02
Author Eiichiro Kanda Department of Nephrology, Tokyo Kyosai Hospital
[ Summary ] There are various types of anemia observed in dialysis patients. Anemia is diagnosed on the basis of the morphological classification of red blood cells. Anemia in dialysis patients is classified as renal anemia caused by decreases in erythropoietin production, iron deficiency, or inflammation. Because renal anemia is sometimes observed along with iron deficiency anemia in dialysis patients, iron metabolism is monitored in terms of transferrin saturation and serum ferritin levels. A patient may have iron deficiency with serum ferritin levels lower than 50 ng/mL. An erythropoiesis-stimulating agent (ESA) is usually the first choice for frequent of anemia in dialysis patients. In cases of apparent iron deficiency, iron replacement medications can be administered to dialysis patients preceding ESA therapy. However, patients should be monitored for adverse effects of iron administration.
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