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| Semin Dial. 2004 Sep-Oct;17(5):336-41. Links
Serum ferritin in chronic kidney disease: reconsidering the upper limit for
iron treatment.
Fishbane S, Kalantar-Zadeh K, Nissenson AR.
Department of Medicine, Winthrop-University Hospital, Mineola, New York.
ABSTRACT 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.
PMID: 15461737 [PubMed - in process]
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Tom
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