Iron deficiency anemia--bridging the knowledge and practice gap

Transfus Med Rev. 2014 Jul;28(3):156-66. doi: 10.1016/j.tmrv.2014.05.001. Epub 2014 May 15.


Despite its high prevalence, anemia often does not receive proper clinical attention, and detection, evaluation, and management of iron deficiency anemia and iron-restricted erythropoiesis can possibly be an unmet medical need. A multidisciplinary panel of clinicians with expertise in anemia management convened and reviewed recent published data on prevalence, etiology, and health implications of anemia as well as current therapeutic options and available guidelines on management of anemia across various patient populations and made recommendations on the detection, diagnostic approach, and management of anemia. The available evidence confirms that the prevalence of anemia is high across all populations, especially in hospitalized patients. Anemia is associated with worse clinical outcomes including longer length of hospital stay, diminished quality of life, and increased risk of morbidity and mortality, and it is a modifiable risk factor of allogeneic blood transfusion with its own inherent risks. Iron deficiency is usually present in anemic patients. An algorithm for detection and management of anemia was discussed, which incorporated iron study (with primary emphasis on transferrin saturation), serum creatinine and glomerular filtration rate, and vitamin B12 and folic acid measurements. Management strategies included iron therapy (oral or intravenous), erythropoiesis-stimulating agents, and referral as needed.

Keywords: Anemia; Anemia, iron-deficiency; Blood transfusion; Hemoglobin; Iron.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Algorithms
  • Anemia, Iron-Deficiency / diagnosis*
  • Anemia, Iron-Deficiency / therapy*
  • Critical Care
  • Erythropoiesis
  • Erythropoietin / therapeutic use
  • Female
  • Ferritins / chemistry
  • Heart Diseases / complications
  • Hematology / methods
  • Hematology / standards
  • Humans
  • Iron / therapeutic use*
  • Male
  • Neoplasms / complications
  • Pregnancy
  • Pregnancy Complications, Hematologic
  • Quality of Life
  • Respiration Disorders / complications
  • Treatment Outcome


  • Erythropoietin
  • Ferritins
  • Iron