| Theme |
Guideline for CKD-related anemia -- looking back twice's revision |
| Title |
What should be the criteria for starting iron therapy ? Should there be an upper limit for iron administration ? |
| Author |
Daigo Kamei |
Department of Medicine, Kidney Center, Tokyo Women's Medical University |
| [ Summary ] |
Serum ferritin and transferrin saturation (TSAT) levels are widely used to evaluate iron status in patients with chronic kidney disease (CKD). In Japan, inter-method variability was small for TSAT and large for ferritin. Slopes from Passing-Bablok regression for the ferritin 10 kits ranged from a minimum of 1.00 to a maximum of 1.63, showing systematic bias. Therefore, treatment of renal anemia in CKD changed significantly owing to differences in the method of measurement. When starting iron therapy and deciding upon the upper limit of the iron administration criteria, the 2015 Japanese Society for Dialysis Therapy (JSDT) anemia guidelines should only be used tentatively, and with regards to the bias seen in the Passing-Bablok regression. |