The iron cycle in chronic kidney disease (CKD): from genetics and experimental models to CKD patients

Nephrol Dial Transplant. 2014 Feb;29(2):263-73. doi: 10.1093/ndt/gft443. Epub 2013 Nov 13.


Iron is essential for most living organisms but iron excess can be toxic. Cellular and systemic iron balance is therefore tightly controlled. Iron homeostasis is dysregulated in chronic kidney disease (CKD) and contributes to the anemia that is prevalent in this patient population. Iron supplementation is one cornerstone of anemia management in CKD patients, but has not been rigorously studied in large prospective randomized controlled trials. This review highlights important advances from genetic studies and animal models that have provided key insights into the molecular mechanisms governing iron homeostasis and its disturbance in CKD, and summarizes how these findings may yield advances in the care of this patient population.

Keywords: anemia; chronic kidney disease; hepcidin; iron; review.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anemia, Iron-Deficiency / genetics
  • Anemia, Iron-Deficiency / metabolism*
  • Animals
  • DNA / genetics
  • Disease Progression
  • Gene Expression Regulation / physiology
  • Genetic Predisposition to Disease*
  • Hepcidins / biosynthesis
  • Hepcidins / genetics
  • Homeostasis / physiology*
  • Humans
  • Iron / metabolism*
  • Models, Theoretical*
  • Renal Insufficiency, Chronic / genetics
  • Renal Insufficiency, Chronic / metabolism*


  • Hepcidins
  • DNA
  • Iron