ABSTRACT
BACKGROUND: Iron Deficiency Anaemia (IDA) has been shown to be the most common cause of anaemia worldwide. It is accepted that people with chronic kidney disease (CKD) develop anaemia as their kidney function declines. METHODS: To better understand IDA in CKD, it is necessary to appreciate the normal iron metabolism and utilisation of iron and how these processes can be disordered in patients with CKD. The problems related to infection / inflammation and oxidative stress are examined. Whilst National and international guidelines recommend specific tests for IDA, these and alternative tests are reviewed. CONCLUSIONS: Whilst iron supplementation is necessary for CKD patients with IDA, iron metabolism and utilisation can be affected by factors such as infection or inflammation. Iron is essential element for all life, it can be toxic to cells through the process of oxidative stress. The recommended tests for IDA may be affected by factors such as infection and inflammation. Alternative tests are available, which may be a more accurate indicator of IDA as they are not affected by external factors.
Subject(s)
Anemia, Iron-Deficiency/nursing , Kidney Failure, Chronic/nursing , Anemia, Iron-Deficiency/blood , Anemia, Iron-Deficiency/diagnosis , Erythropoietin/administration & dosage , Guideline Adherence , Hepcidins/blood , Humans , Infections/blood , Infections/diagnosis , Infections/nursing , Inflammation/blood , Inflammation/diagnosis , Inflammation/nursing , Iron/administration & dosage , Iron/blood , Kidney Failure, Chronic/blood , Kidney Failure, Chronic/diagnosis , Oxidative Stress/physiology , Reference ValuesABSTRACT
SUMMARY Anaemia is an almost universal issue that develops in the later stages of chronic kidney disease (CKD) primarily due to a lack of erythropoietin (EPO) and the depressed EPO response in bone marrow. This can have a profound effect on the patient's lifestyle and quality of life. Knowledge of both the psychosocial and clinical areas of CKD is imperative for healthcare professionals so that they can be at the forefront of improvements of CKD patient care.
