Iron management in renal failure patients — How do we achieve the best results?

Abstract

The majority of patients with renal insufficiency suffer from a normochromic, normocytic anaemia. This renal anaemia affects the quality of life of these patients and reduces their chance of survival. Despite the availability of recombinant human erythropoetin for the treatment of renal anaemia, many patients do not achieve the target haemoglobin concentration of more than 11 g/dl. A major factor contributing to suboptimal correction of renal anaemia and reduced responsiveness to epoetin is a lack of iron availability to the stimulated erythropoesis.Thus, forthe majority of patients with renal insufficiency intravenous iron therapy will be the treatment of choice to replete and maintain adequate iron stores.

Parenteral iron compounds sensitize mice to injury-initiated TNF-α mRNA production and TNF-α release

“…Multiplex PCR was possible due to the primers' similar annealing temperatures but dissimilar sizes of the two PCR products. PCR conditions were optimized for each tissue (37 cycles for TNF-␣ in all tissues; 18,22,19,25, and 25 GAPDH cycles for kidney, liver, heart, spleen, and lung, respectively). PCR products were analyzed by agarose gel electrophoresis and ethidium bromide staining.…”

“…PARENTERAL IRON THERAPY HAS become a mainstay in anemia management in patients with progressive or end-stage renal disease (ESRD) (15,17,18). Its need stems from a variety of factors, including low iron intake or absorption, dialysis-dependent blood loss, and/or "functional" deficiency, defined as an insufficient amount of bioavailable iron to support maximal erythropoietin-stimulated erythropoiesis.…”