title: Iron deficiency anaemia in chronic kidney disease.
abstract: BACKGROUND
  Iron Deficiency Anaemia (IDA) has been shown to be the most common cause of anaemia worldwide. It is accepted that people with chronic kidney disease (CKD) develop anaemia as their kidney function declines.
  
  
  METHODS
  To better understand IDA in CKD, it is necessary to appreciate the normal iron metabolism and utilisation of iron and how these processes can be disordered in patients with CKD. The problems related to infection / inflammation and oxidative stress are examined. Whilst National and international guidelines recommend specific tests for IDA, these and alternative tests are reviewed.
  
  
  CONCLUSIONS
  Whilst iron supplementation is necessary for CKD patients with IDA, iron metabolism and utilisation can be affected by factors such as infection or inflammation. Iron is essential element for all life, it can be toxic to cells through the process of oxidative stress. The recommended tests for IDA may be affected by factors such as infection and inflammation. Alternative tests are available, which may be a more accurate indicator of IDA as they are not affected by external factors.
authors.affiliation: Oxford University Hospitals NHS Trust, Oxford Kidney Unit, Churchill Hospital, Oxford, UK. iain.wittwer@ouh.nhs.uk
authors.forename: Iain
authors.initials: I
authors.lastname: Wittwer
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis / Q000451:nursing*; D004921:Erythropoietin / Q000008:administration & dosage; D019983:Guideline Adherence; D064451:Hepcidins / Q000097:blood; D006801:Humans; D007239:Infections / Q000097:blood / Q000175:diagnosis / Q000451:nursing; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000451:nursing; D007501:Iron / Q000008:administration & dosage / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000451:nursing*; D018384:Oxidative Stress / Q000502:physiology; D012016:Reference Values
chemical_list: D064451:Hepcidins; D004921:Erythropoietin; D007501:Iron
keywords: Diagnostic tests; Inflammatory response; Iron deficiency anaemia; Iron metabolism; Oxidative stress