Anemia in Peritoneal Dialysis Patients; Iron Repletion, Current and Future Therapies.
Study Goal
The researchers aimed to review the rationale, methods, adverse effects, and long-term concerns of iron therapy in peritoneal dialysis (PD) patients, as well as highlight potential future therapies.
Results Summary
The study found that intravenous (IV) iron supplementation is more effective than oral iron for replenishing and maintaining iron stores in CKD and PD patients, though concerns remain about labile iron and infection risks. Limited data exists specifically for PD patients compared to hemodialysis (HD) patients.
Population
Patients with chronic kidney disease (CKD), particularly those on peritoneal dialysis (PD).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Oral iron | no change | hemoglobin concentrations | patients with chronic kidney disease (CKD) | - | insufficient and slow to improve | #1 |
intravenous (IV) supplementation | increase | iron stores | patients with chronic kidney disease (CKD) | - | replenishes and maintains more effectively | #2 |
Iron deficiency, both functional and absolute, is common in patients with chronic kidney disease (CKD), especially those requiring dialysis. Guidelines advocate treatment of iron-deficiency anemia in patients with CKD and those on peritoneal dialysis (PD). Oral iron is often insufficient and slow to improve hemoglobin concentrations because of high hepcidin levels causing impaired absorption and mobilization, while intravenous (IV) supplementation replenishes and maintains iron stores more effectively and is now standard practice (Kidney Disease Improving Global Outcomes [KDIGO] 2012 guidelines). However, there still remain concerns about the effects of labile iron and possible increased risk of infections for this group of patients.To date, the majority of published studies have focused on hemodialysis (HD) patients; very limited data are available regarding patients on PD. This review summarizes the rationale for iron therapy, methods of treatment, potential adverse effects, and long-term concerns in PD patients. In addition we highlight some interesting potential future therapies under study.