[Iron deficiency is a common cause of bad response to epoetin treatment. It's important to follow iron status--not only the Hb value].
Anaemia in patients with chronic kidney disease can be treated with epoetin. An adequate iron status is necessary for an optimal epoetin treatment effect. Guidelines from the Swedish Association of Nephrology recommend that haemoglobin (Hb) and iron status should be investigated every 3 - 6 months. Recommended target values are 110-130 g/l (Hb), >20% (transferrin saturation) and >100 microg/l (S-ferritin). A cross-sectional study was performed in 173 pre-dialysis patients (GFR <20 ml/minx1.73 m2 BSA), 35% of whom received epoetin. In epoetin-treated patients, laboratory investigations as recommended in the guidelines were present for 100% (Hb), 67% (transferrin saturation) and 62% (S-ferritin) of the patients. In these patients, target values were reached for 57% (Hb), 66% (transferrin saturation) and 58% (S-ferritin). Forty percent of the epoetin-treated patients had absolute iron deficiency, 60% of whom received iron therapy. In conclusion, adherence to guidelines concerning epoetin and iron therapy in patients with chronic kidney disease could probably be improved.
Wallerstedt
Susanna M
SM
Sektionen för klinisk farmakologi, Sahlgrenska Universitetssjukhuset/Sahlgrenska, SE-413 45 Göteborg, Sweden. susanna.wallerstedt@pharm.gu.se
Ljungman
Susanne
S
Broms
Ellinor
E
Andrén
Lennart
L
D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D003430:Cross-Sectional Studies; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D005293:Ferritins / Q000097:blood; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006397:Hematinics / Q000008:administration & dosage*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D007676:Kidney Failure, Chronic / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D014168:Transferrin / Q000032:analysis
D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D014168:Transferrin; D004921:Erythropoietin; D000068817:Epoetin Alfa; D005293:Ferritins; D007501:Iron