Erythropoietin and iron

Clin Nephrol. 1997 Mar;47(3):141-57.

Abstract

Careful evaluation of iron status is of pivotal importance in end-stage renal disease patients before and during r-HuEPO therapy. Absolute (ferritin < 100 micrograms/l) and functional (ferritin normal or supranormal, transferrin saturation < 20%, hypochromic red blood cell [RBC] > 5%) iron deficiency are the main reasons for r-HuEPO hyporesponsiveness. Adequate iron supplementation allows significant reduction of r-HuEPO dosage and costs. Oral iron supplementation is recommended for predialysis and peritoneal dialysis patients with serum ferritin > 100 micrograms/l, whereas i.v. iron supplementation is the therapy of choice in hemodialysis patients. However, neutrophil impairment and other possible side-effects (e.g. cardiovascular complications, malignancy) as a result of i.v. iron therapy suggest that overtreatment with i.v. iron should be avoided.

Publication types

  • Review

MeSH terms

  • Aluminum / blood
  • Enzyme Inhibitors / blood
  • Erythrocytes / metabolism*
  • Erythropoietin / economics
  • Erythropoietin / therapeutic use*
  • Ferritins / blood
  • Hemoglobins / metabolism
  • Humans
  • Iron / deficiency*
  • Iron / metabolism
  • Iron / therapeutic use*
  • Kidney Failure, Chronic / drug therapy*
  • Protoporphyrins / blood
  • Recombinant Proteins
  • Transferrin / metabolism

Substances

  • Enzyme Inhibitors
  • Hemoglobins
  • Protoporphyrins
  • Recombinant Proteins
  • Transferrin
  • Erythropoietin
  • zinc protoporphyrin
  • Ferritins
  • Aluminum
  • Iron