[Iron therapy in chronic kidney disease]

Area of Science:

• Nephrology
• Hematology
• Pharmacology

Background:

• Iron deficiency is a primary cause of anemia in chronic kidney disease (CKD).
• Erythropoietin and iron supplementation form the cornerstone of anemia management in CKD patients.
• Intravenous iron is preferred for hemodialysis patients, but its use in non-dialysis CKD is debated.

Purpose of the Study:

• To evaluate the efficacy and safety of different iron supplementation routes in non-dialysis CKD patients.
• To explore modern oral iron formulations as a potential alternative to intravenous iron therapy.

Main Methods:

• Review of existing literature on oral versus intravenous iron administration in CKD.
• Analysis of absorption rates, efficacy, gastrointestinal side effects, and allergic reactions associated with different iron formulations.

Main Results:

• Oral iron, though inexpensive and convenient, suffers from poor absorption and frequent gastrointestinal side effects, often leading to treatment cessation.
• Intravenous iron is effective but carries risks including allergic reactions, oxidative stress, and iron overload.
• Emerging oral iron medications show promise for improved efficacy and tolerability.

Conclusions:

• The optimal route of iron administration for non-dialysis CKD patients remains a significant clinical question.
• Modern oral iron therapies may offer a viable and safer alternative to intravenous iron, addressing limitations of traditional oral iron treatments.