What's the Latest on Iron Therapy?

Abstract

Anemia is a common complication of chronic kidney disease (CKD) and is usually treated with erythropoiesis-stimulating agents (ESA) and iron supplementation. Endovenous iron therapy has been recently ruled (and limited) by both the European and Italian medicines agencies due to serious, despite rare, adverse events. A recent analysis of data from the Dialysis Outcomes and Practice Patterns Study (DOPPS) has shown an association between high endovenous iron therapy (more than 300 mg/month) and increased mortality in patients with hemoglobin levels higher than 10 g/dL. The new molecules available on the market should have a better safety profile and several advantages related to the possibility of administering a high iron dose in a single infusion. Iron supplementation through the dialysate and through new phosphate binders demonstrates the great scientific interest in this important field, also to the advantage of our CKD patients.