Anemia in Peritoneal Dialysis Patients; Iron Repletion, Current and Future Therapies.
Iron deficiency, both functional and absolute, is common in patients with chronic kidney disease (CKD), especially those requiring dialysis. Guidelines advocate treatment of iron-deficiency anemia in patients with CKD and those on peritoneal dialysis (PD). Oral iron is often insufficient and slow to improve hemoglobin concentrations because of high hepcidin levels causing impaired absorption and mobilization, while intravenous (IV) supplementation replenishes and maintains iron stores more effectively and is now standard practice (Kidney Disease Improving Global Outcomes [KDIGO] 2012 guidelines). However, there still remain concerns about the effects of labile iron and possible increased risk of infections for this group of patients.To date, the majority of published studies have focused on hemodialysis (HD) patients; very limited data are available regarding patients on PD. This review summarizes the rationale for iron therapy, methods of treatment, potential adverse effects, and long-term concerns in PD patients. In addition we highlight some interesting potential future therapies under study.
Department of Academic Renal Research, Hull and East Yorkshire Hospital Trust and Hull York Medical School, Kingston Upon Hull, UK.
Ahmed
A
Zeidan
Department of Academic Renal Research, Hull and East Yorkshire Hospital Trust and Hull York Medical School, Kingston Upon Hull, UK sunil.bhandari@hey.nhs.uk.
Sunil
S
Bhandari
D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005290:Ferric Compounds / Q000627:therapeutic use*; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome; D006113:United Kingdom
D005290:Ferric Compounds; D006397:Hematinics
Anemia; hemodialysis; hepcidin; intravenous; iron deficiency; oxidative stress; peritoneal dialysis