علاج فقر الدم الناجم عن مرض الكلى المزمن في مرض الكلى المزمن G5 الخاضع لغسيل الكلى البريتوني

DOI: 10.1016/j.kint.2025.06.006

In people with anemia and CKD not receiving dialysis or CKD G5 receiving peritoneal dialysis (CKD G5PD), we suggest initiating iron if (2D): Ferritin <100 ng/ml (<100 μg/l) and TSAT <40% or Ferritin ≥100 ng/ml (≥100 μg/l) and <300 ng/ml (<300 μg/l), and TSAT <25%.

In people with anemia and CKD not receiving hemodialysis (HD) in whom iron is initiated, we suggest using either oral iron or i.v. iron based on the person's values and preferences, the degree of anemia and iron deficiency, and the relative efficacy, tolerability, availability, and cost of each (2D).

In people with CKD treated with iron, it is reasonable to withhold routine iron if ferritin >700 ng/ml (>700 μg/l) or TSAT ≥40%.

Iron probably increases the Hb concentration on average by ~0.65–1.0 g/dl (~6.5–10 g/l) compared with no iron.

In people with CKD treated with iron, it is reasonable to test hemoglobin (Hb), ferritin, and TSAT every 3 months for those with CKD not receiving dialysis or CKD G5PD and every 1–3 months for those with CKD G5HD.