Issues related to iron replacement in chronic kidney disease

被引:28
作者
Agarwal, R
Warnock, D
机构
[1] Indiana Univ, Dept Med, Div Nephrol, Indianapolis, IN 46202 USA
[2] RLR VA Med Ctr, Indianapolis, IN 46202 USA
[3] Univ Alabama Birmingham, Nephrol Res & Training Ctr, Birmingham, AL USA
关键词
D O I
10.1053/snep.2002.35972
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Recent epidemiologic studies show that iron deficiency occurs in the vast majority of patients with chronic kidney disease (CKD). In patients with CKD, increased iron losses and, to a lesser extent, poor oral absorption, can lead to iron-deficiency anemia. Correction of iron-deficiency anemia is preferable by the oral route, however, data on oral iron use are limited in this population. In CKD patients, parenteral iron administered with recombinant human erythropoietin (rHuEpo), is the best potential option for the correction of anemia. Nondextran iron preparations are preferable because of a reduced incidence of serious adverse events. Parenteral iron in CKD patients may not be entirely innocuous and, although commonly used, have not received Food and Drug Administration approval for use in this patient population. Exposure to intravenous (IV) iron may lead to oxidative stress, renal injury, infection, cardiovascular disease, and osteomalacia. Studies are needed to confirm the existence and magnitude of these complications. The current data suggest that the overall risk-benefit ratio favors use of IV iron when compared with untreated or partially treated iron-deficiency anemia. Copyright 2002, Elsevier Science (USA). All rights reserved.
引用
收藏
页码:479 / 487
页数:9
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