2017
DOI: 10.1111/hdi.12562
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Clinical practice guidelines on iron therapy: A critical evaluation

Abstract: Anemia is common among patients with chronic kidney disease (CKD) and it is managed primarily with erythropoiesis-stimulating agents (ESA) and iron therapy. Following concerns around ESA therapy and economic constraints, IV iron is more and more administered worldwide.Several guidelines or position papers, which give indications on iron therapy in CKD patients, have been issued in Nephrology. Unfortunately, the field is characterized by a lack of evidence. As a result, the recommendations/suggestions are not u… Show more

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Cited by 8 publications
(8 citation statements)
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“…The French National Agency for the Safety of Medicines and Health Product (ANSM, Saint-Denis, France), Canadian guidelines and other investigators recommend that it is appropriate to use OIT in first intention due to its lower toxicity, regardless of ND-CKD or HD patients [ 52 , 126 , 177 , 178 ]. Several international guidelines also recommend that OIT should be administered first in ND-CKD patients [ 52 , 58 , 59 ], while other guidelines recommend that IIT be firstly used in HD patients [ 51 , 54 , 55 , 58 , 59 ].…”
Section: Safety Issues Of Iron Therapymentioning
confidence: 99%
“…The French National Agency for the Safety of Medicines and Health Product (ANSM, Saint-Denis, France), Canadian guidelines and other investigators recommend that it is appropriate to use OIT in first intention due to its lower toxicity, regardless of ND-CKD or HD patients [ 52 , 126 , 177 , 178 ]. Several international guidelines also recommend that OIT should be administered first in ND-CKD patients [ 52 , 58 , 59 ], while other guidelines recommend that IIT be firstly used in HD patients [ 51 , 54 , 55 , 58 , 59 ].…”
Section: Safety Issues Of Iron Therapymentioning
confidence: 99%
“…Indications when i.v. iron therapy should be initiated are not that straight forward, based on the low grade of available evidence, and heterogeneity between guidelines for different disease entities [128]. However, i.v.…”
Section: Treatment Strategiesmentioning
confidence: 99%
“…Furthermore, two recent studies showed conflicting results regarding whether there may be a benefit [ 17 ] or no benefit [ 18 ] to starting dialysis therapy with a higher Hgb level. Controversy also remains in identifying optimal strategies for iron supplementation in non-dialysis CKD and ESKD [ 19–23 ]. In the non-dialysis CKD setting, the efficacy of IV iron to raise or sustain Hgb levels has been well-established, but most RCTs do not have sufficient follow-up to evaluate long-term safety [ 24 ].…”
Section: Introductionmentioning
confidence: 99%