| Theme |
Iron and bone metabolism |
| Title |
Risks of iron supplementation in chronic kidney disease |
| Author |
Shigeichi Shoji |
Department of Internal Medicine, Shirasagi Hospital |
| Author |
Masaaki Inaba |
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine |
| [ Summary ] |
Iron is a transitional element, changing easily between Fe2+ and Fe3+ with the exchange of electrons through reduction/oxidation reactions. The resultant structures work in direct coordination with oxygen. Excessive iron loading is harmful. Doses of supplemental iron should be minimanized.
Changes in hepcidin levels alter the efficacy of iron use. Intravenous iron administration promptly raises hepcidin levels, transiently stopping iron from entering bone marrow. Due to this evidence oral iron supplementation is favored. Long-term erythropoiesis-stimulating agents (ESA) provide more effective erythropoiesis than short acting ESA, sustaining hepcidin levels longer. |