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Treatment of iron deficiency anaemia from the nephrologist's point of view

Publication at Second Faculty of Medicine |
2014

Abstract

Renal anaemia is principally caused by erythropoietin deficiency. Chronic kidney disease is commonly accompanied by development of anaemia that is characterised by poor intestinal iron (Fe) absorption and low ferritin levels.

Thus, anaemia with a sideropenic component requires erythropoietin as well as Fe supplementation. The effect of oral Fe preparations is limited by their reduced absorption rate and gastrointestinal side-effects.

The introduction of second-generation intravenous Fe preparations (iron sucrose and ferric gluconate) reduces the risk of anaphylactic reactions but cannot be administered in large doses and the typical 1000 mg therapy requires several clinic visits. Ferric carboxymaltose offers an effective and rapid correction of iron deficiency.

It can be administered in a large replenishment dose (1000 mg) over a short infusion period (15-30 min), typically to the amount required for complete iron repletion.