Treatment Considerations for Adult Patients With IDA and CKD^a

Initiating iron therapy

• KDOQI™ recommendations⁷:
  
  
  • Anemia therapy in patients with chronic kidney disease (CKD)^a requires effective use of iron agents, guided by appropriate testing of iron status
  
  
  • Intravenous (IV) iron agents may serve as primary therapy for certain patients, particularly those with dialysis dependent (DD) CKD
  
  
  • Initiate therapy at transferrin saturation (TSAT) <20% and serum ferritin <100 ng/mL

Treatment considerations

• Evaluating response to treatment is an important step in anemia management


• Iron parameters and hemoglobin (Hgb) should be considered in combination to evaluate the cause of anemia before treatment is initiated⁷


• Treatment of iron deficiency anemia (IDA) with IV iron may cause an increase in Hgb, with or without an erythropoiesis stimulating agent (ESA)


• ESA therapy⁷
  
  
  • An evaluation of the cause of anemia should precede initiation of ESA therapy
  
  
  • Patients receiving ESAs may also require iron supplementation

^aKDOQI™ Guidelines refer to patients with chronic renal insufficiency (CRI) as having chronic kidney disease (CKD), while others refer to them as having end-stage renal disease (ESRD) in more severe cases. CKD, CRI, and ESRD all refer to kidney disease. Upon establishing the KDOQI™ Guidelines, the National Kidney Foundation (NKF) adopted the term CKD as a universal term to highlight all those who are affected by kidney disease.

KDOQI=Kidney Disease Outcomes Quality Initiative.

KDOQI is a trademark of the National Kidney Foundation, Inc.

Now that you know about Treatment Considerations, learn more about Iron Treatment Goals.