Iron Deficiency Anemia Treatment in Chronic Kidney Disease

Primary Indications

• The American Journal of Kidney Diseases recommends treatment of iron deficiency anemia in hemodialysis-dependent CKD patients receiving erythropoiesis-stimulating agents (ESAs) 1, 2
• The Gut journal suggests that peritoneal dialysis patients with documented iron deficiency should receive iron sucrose treatment 3, 4

Clinical Context for Use in CKD

• Iron deficiency is a major contributor to anemia in CKD, particularly when GFR falls below 60 mL/min/1.73m², according to the Gut journal 3, 4
• The American Journal of Kidney Diseases states that oral iron fails to maintain adequate iron stores in most hemodialysis patients, resulting in persistent moderate anemia that increases morbidity and mortality 5
• Erythropoiesis requires both iron and erythropoietin, and iron supplementation is essential to ensure adequate response to ESA therapy, as recommended by the American Journal of Kidney Diseases 1, 2

Defining Iron Deficiency in CKD

• Absolute iron deficiency in CKD is defined as transferrin saturation ≤20% and serum ferritin ≤100 μg/L (predialysis and peritoneal dialysis patients) or ≤200 μg/L (hemodialysis patients), according to the American Journal of Kidney Diseases and the Gut journal 3, 4, 6, 7

Clinical Outcomes Supporting Use

• Effective treatment of anemia in CKD improves survival, decreases morbidity, and increases quality of life, as stated by the American Journal of Kidney Diseases 1, 2

Key Clinical Pitfalls to Avoid

• The Praxis Medical Insights guideline recommends avoiding administration of Venofer to patients with known hypersensitivity to iron sucrose, iron overload, or active bacteremia 8