علاج فقر الدم في مرض الكلى المزمن G5 على غسيل الكلى عندما لم يحقق الحديد الوريدي الأهداف المطلوبة

References

DOI: 10.1016/j.kint.2025.06.006

• In people with anemia and CKD G5 receiving hemodialysis (CKD G5HD), we suggest initiating iron therapy if ferritin ≤500 ng/ml (≤500 μg/l) and TSAT ≤30% (2D).
• In people with anemia and CKD in whom correctable causes of anemia have been addressed, we suggest using an ESA rather than a HIF-PHI as first-line treatment of anemia (2D).
• In people with anemia and CKD G5D receiving HD or peritoneal dialysis, we suggest initiation of ESA therapy when the Hb concentration is ≤9.0–10.0 g/dl (≤90–100 g/l) (2D).
• In adults with anemia and CKD treated with ESAs, we recommend targeting the Hb level to below 11.5 g/dl (115 g/l) (1D).
• Initial therapy with an ESA aims to increase the Hb concentration by 1.0 g/dl (10 g/l) per month, which is consistent with the findings in clinical trials that used an ESA to treat anemia in people with CKD G5D and CKD not receiving dialysis.