A field guide to iron needs in the patient on hemodialysis.
It is essential for nephrology nurses to understand the basics of iron function and the importance of maintaining iron balance in their patients. Iron forms the cornerstone of oxygen delivery in the body and is the most essential nutrient for the building of healthy erythrocytes. Given the vital importance of iron, the body has devised elaborate and tightly controlled mechanisms to transport iron to the bone marrow for hemoglobin production, recycle iron from dying erythrocytes, and prevent iron loss. In the healthy individual, daily iron intake needs are very small, and sufficient iron is easily absorbed from the duodenum. In patients on hemodialysis, this iron balance is dramatically altered due to blood loss, inflammation, and the use of erythropoiesis-stimulating agents. This article discusses the basics of iron physiology and the mechanisms by which iron is moved throughout the body and made available for developing erythrocytes. The ways in which iron balance is altered in the patient on hemodialysis and the most effective strategies to replete iron stores and maintain iron balance through the use of intravenous iron are also reviewed.
Wick
Gail
G
D018798:Anemia, Iron-Deficiency / Q000150:complications; D005260:Female; D006801:Humans; D007501:Iron / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis
D007501:Iron