The effects of oral iron supplementation on the progression of anemia and renal dysfunction in patients with chronic kidney disease

Kim, Seon Mee; Ch, Lee; Yk, Oh; Kw, Joo; Ys, Kim; S, Kim; Cs, Lim

doi:10.5414/cnp75472

Cited by 8 publications

(5 citation statements)

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“…This is often due to poor dietary intake or bleeding, eventually leading to a reduction in formation of red blood cell Hb, causing hypochromic microcytic anemia (Fishbane and Singh 2009). Thus, iron supplementation is necessary for optimal management of anemia and can in fact attenuate the progression of anemia in CKD (Kim et al 2011). …”

Section: Discussionmentioning

confidence: 99%

Predictors of anemia in a multi-ethnic chronic kidney disease population: a case–control study

et al. 2015

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Anemia is a common complication of chronic kidney disease (CKD). However, risk factors of anemia in CKD patients in Singapore are not well established. Hence, a retrospective, case–control study involving non-dialysis CKD patients was conducted to determine possible predictors of anemia in the local CKD population.Non-dialysis adult CKD patients, not receiving renal replacement therapy or erythropoiesis-stimulating-agents were included. Parameters collected included demographics e.g. age, sex and race; clinical data e.g. CKD stage and medical/medication histories; and laboratory data e.g. serum electrolytes, urinary and hematologic parameters. Patients were classified as anemic or non-anemic using a threshold hemoglobin level of 10 g/dL. The parameters were evaluated for their predictive value for anemia development using multivariate logistical regression and calculation of odds ratios. Statistical analyses were performed using STATA.A total of 457 patients (162 anemic and 295 non-anemic) were analysed. Multivariate analysis showed that probability of developing anemia was greater for patients with stage 5 CKD (OR 16.76, p < 0.001), with hematological disorders (OR 18.61, p < 0.001) and with respiratory disorders (OR 4.54, p = 0.004). The probability of developing anemia was lower for patients with higher previous hemoglobin concentration (OR 0.32, p < 0.001) and in those receiving iron supplements (OR 0.44, p = 0.031). Gender and race were not found to be significant predictors of anemia.Risk of anemia is increased in patients with advanced CKD, haematological disorders, respiratory disorders, and those not taking iron supplements. This study has increased our understanding of the patient subgroups at risk for anemia.

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Section: Discussionmentioning

confidence: 99%

Predictors of anemia in a multi-ethnic chronic kidney disease population: a case–control study

et al. 2015

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“…Similarly, atherosclerotic change was correlated with serum levels of ferritin and doses of IV iron in HD patients [ 188 ]. OIT improved anemia in ND-CKD patients without affecting renal function [ 189 ], while IV iron sucrose increased proteinuria in ND-CKD patients, indicating that high doses of IV iron may aggravate kidney injury [ 190 ]. Repeated administration of IV iron in HD patients increased oxidative DNA injury and serum ferritin, suggesting that excess body iron stores caused by aggressive IIT might promote oxidative stress [ 191 ].…”

Section: Safety Issues Of Iron Therapymentioning

confidence: 99%

Impact of Inflammation on Ferritin, Hepcidin and the Management of Iron Deficiency Anemia in Chronic Kidney Disease

2018

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Iron deficiency anemia (IDA) is a major problem in chronic kidney disease (CKD), causing increased mortality. Ferritin stores iron, representing iron status. Hepcidin binds to ferroportin, thereby inhibiting iron absorption/efflux. Inflammation in CKD increases ferritin and hepcidin independent of iron status, which reduce iron availability. While intravenous iron therapy (IIT) is superior to oral iron therapy (OIT) in CKD patients with inflammation, OIT is as effective as IIT in those without. Inflammation reduces predictive values of ferritin and hepcidin for iron status and responsiveness to iron therapy. Upper limit of ferritin to predict iron overload is higher in CKD patients with inflammation than in those without. However, magnetic resonance imaging studies show lower cutoff levels of serum ferritin to predict iron overload in dialysis patients with apparent inflammation than upper limit of ferritin proposed by international guidelines. Compared to CKD patients with inflammation, optimal ferritin levels for IDA are lower in those without, requiring reduced iron dose and leading to decreased mortality. The management of IDA should differ between CKD patients with and without inflammation and include minimization of inflammation. Further studies are needed to determine the impact of inflammation on ferritin, hepcidin and therapeutic strategy for IDA in CKD.

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“…Previous studies have suggested that anemia may aggravate CKD, and pointed out that the early prevention of anemia is important in CKD patients [31,32,33]. Since oral iron supplementation is effective in preventing the progression of anemia [34], sufficient iron intake may prevent the development or progression of CKD by correcting anemia.…”

Section: Discussionmentioning

confidence: 99%

Association between Dietary Mineral Intake and Chronic Kidney Disease: The Health Examinees (HEXA) Study

Kim

Lee

Kim

et al. 2018

IJERPH

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Few studies have explored the association between mineral intake and chronic kidney disease (CKD). A cross-sectional analysis investigated the association between mineral intake (calcium, phosphorus, sodium, potassium, iron, and zinc) and CKD using the Health Examinee (HEXA) cohort of the Korean Genome and Epidemiologic Study (KoGES). For 159,711 participants, mineral intake was assessed by a food frequency questionnaire. CKD was defined as an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m2. Dietary intake of each mineral was divided into quartiles and the quartile including recommended dietary allowance (RDA) or adequate intake (AI) of each mineral was used as a reference. We assessed the association between the quartile of mineral intakes and CKD using polytomous logistic regression models. The lowest quartiles of phosphorus (≤663.68 mg/day, odds ratio [OR] = 1.64, 95% confidence interval [CI]: 1.25–2.15), potassium (≤1567.53 mg/day, OR = 1.87, 95% CI: 1.27–2.75), iron (≤6.93 mg/day, OR = 1.53, 95% CI: 1.17–2.01), and zinc (≤5.86 mg/day, OR = 1.52, 95% CI: 1.02–2.26) were associated with higher odds for advanced CKD compared with the references. The present study suggests that an inadequate intake of some minerals may be associated with CKD occurrence in the general population. Due to the reverse causation issue in this cross-sectional study design, further longitudinal prospective studies are needed in order to prove the results.

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The effects of oral iron supplementation on the progression of anemia and renal dysfunction in patients with chronic kidney disease

Cited by 8 publications

References 0 publications

Predictors of anemia in a multi-ethnic chronic kidney disease population: a case–control study

Predictors of anemia in a multi-ethnic chronic kidney disease population: a case–control study

Impact of Inflammation on Ferritin, Hepcidin and the Management of Iron Deficiency Anemia in Chronic Kidney Disease

Association between Dietary Mineral Intake and Chronic Kidney Disease: The Health Examinees (HEXA) Study

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