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Serum Ferritin in Chronic Kidney Disease: Reconsidering the Upper Limit for Iron Treatment
Author(s) -
Fishbane Steven,
KalantarZadeh Kamyar,
Nissenson Allen R.
Publication year - 2004
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.0894-0959.2004.17359.x
Subject(s) - medicine , intravenous iron , erythropoietin , ferritin , intensive care medicine , context (archaeology) , hemodialysis , kidney disease , hematocrit , hemoglobin , anemia , disease , iron deficiency , paleontology , biology
Intravenous iron treatment in hemodialysis patients improves the response to recombinant human erythropoietin (rHuEPO) and facilitates achievement of targets for hemoglobin and hematocrit. Excessive treatment, however, could expose patients to risks related to iron overload and oxidative stress. Therefore international treatment guidelines generally recommend that intravenous iron be discontinued when serum ferritin is greater than 500–1000 ng/ml. In this article we explore the relevant issues that inform the decisions as to what levels of serum ferritin are used as the upper limit for treatment. We conclude that the current published literature is inadequate for developing evidence‐based guidelines. Clinical judgment is critical to properly weigh the risks and benefits of intravenous iron treatment in the context of the individual patient.