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Iron-Deficiency Anemia in CKD: A Narrative Review for the Kidney Care Team
Debra Hain1, Donna Bednarski2, Molly Cahill3
1Florida Atlantic University, Boca Raton, FL.
Insights
Iron-deficiency anemia is a common issue in chronic kidney disease (CKD). This review highlights how the kidney care team can better diagnose and manage this condition, improving patient outcomes.
Area of Science:
- Nephrology
- Hematology
- Nutritional Science
Background:
- Anemia is a frequent complication of chronic kidney disease (CKD), linked to higher mortality and lower quality of life.
- Anemia involves decreased hemoglobin, essential for oxygen transport, and iron is crucial for hemoglobin production.
- Disrupted iron homeostasis can cause iron-deficiency anemia, a significant clinical challenge in CKD management.
Purpose of the Study:
- To review iron-deficiency anemia in CKD, focusing on diagnosis and management strategies.
- To describe the mechanisms of iron homeostasis and the complications of iron-deficiency anemia.
- To identify challenges in diagnosing and treating iron-deficiency anemia in CKD patients.
Main Methods:
- Literature review of iron homeostasis, anemia in CKD, and multidisciplinary care approaches.
- Analysis of current diagnostic and treatment challenges for iron-deficiency anemia in CKD.
- Exploration of the roles of various healthcare professionals in managing anemia.
Main Results:
- Iron-deficiency anemia requires careful assessment and management within the CKD care continuum.
- Multidisciplinary team involvement, including dietitians, can enhance patient care.
- Current diagnostic and treatment methods for iron-deficiency anemia in CKD present unmet needs.
Conclusions:
- Optimizing the diagnosis and management of iron-deficiency anemia in CKD is crucial.
- Each member of the kidney care team has opportunities to contribute to improved patient outcomes.
- Addressing iron homeostasis and nutritional status is key for CKD patients with anemia.
Abstract:
Anemia is a common complication of chronic kidney disease (CKD) and is associated with increased mortality and reduced health-related quality of life. Anemia is characterized by a decrease in hemoglobin, the iron-rich protein that the body uses for oxygen transport. Iron is required to produce hemoglobin, and disruptions in the iron homeostasis can lead to iron-deficiency anemia. Management of anemia in individuals with CKD is typically performed by a team of physicians, nurse practitioners, physician assistants, or registered nurses. Throughout the care continuum, the management can be enhanced by multidisciplinary care, and individuals with CKD can benefit from the involvement of other specialties, with dietitians/nutritionists playing an important role. However, a key area of unmet clinical need is how to assess and address iron-deficiency anemia. This review aims to provide an overview of iron-deficiency anemia in CKD and how this may be diagnosed and managed by the entire kidney care team, such as describing the mechanisms underlying iron homeostasis, the complications of iron-deficiency anemia, and the current challenges associated with its diagnosis and treatment in CKD. Opportunities for each multidisciplinary team member to add value to the care of individuals with CKD and iron-deficiency anemia are also described.
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