title: Disorders of Iron Metabolism and Anemia in Chronic Kidney Disease.
abstract: Dysregulated iron homeostasis plays a central role in the development of anemia of chronic kidney disease (CKD) and is a major contributor toward resistance to treatment with erythropoiesis-stimulating agents. Understanding the underlying pathophysiology requires an in-depth understanding of normal iron physiology and regulation. Recent discoveries in the field of iron biology have greatly improved our understanding of the hormonal regulation of iron trafficking in human beings and how its alterations lead to the development of anemia of CKD. In addition, emerging evidence has suggested that iron homeostasis interacts with bone and mineral metabolism on multiple levels, opening up new avenues of investigation into the genesis of disordered iron metabolism in CKD. Building on recent advances in our understanding of normal iron physiology and abnormalities in iron homeostasis in CKD, this review characterizes how anemia related to disordered iron metabolism develops in the setting of CKD. In addition, this review explores our emerging recognition of the connections between iron homeostasis and mineral metabolism and their implications for the management of altered iron status and anemia of CKD.
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL. Electronic address: bhupesh@uab.edu.
authors.forename: Bhupesh
authors.initials: B
authors.lastname: Panwar
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Orlando M
authors.initials: OM
authors.lastname: Gutiérrez
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000378:metabolism*; D027682:Cation Transport Proteins / Q000378:metabolism; D005293:Ferritins / Q000378:metabolism; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000378:metabolism; D064451:Hepcidins / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D007408:Intestinal Absorption; D007501:Iron / Q000378:metabolism*; D019266:Iron, Dietary / Q000378:metabolism; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000378:metabolism*; D014807:Vitamin D / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000150:complications / Q000378:metabolism*; D000098742:Ferroportin
chemical_list: D027682:Cation Transport Proteins; D064451:Hepcidins; D019266:Iron, Dietary; D000098742:Ferroportin; D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D005293:Ferritins; D007501:Iron
keywords: Hepcidin; anemia of chronic kidney disease; chronic kidney disease; fibroblast growth factor 23; iron metabolism; vitamin D