Iron therapy in Chronic Kidney disease what you need to know

Chronic kidney disease (CKD) is a gradual and usually permanent loss of kidney function over time. This happens gradually over time, usually months to years.

CKD is divided into 5 stages of increasing severity. Stage 5 chronic kidney failure is also referred to as end-stage renal disease, wherein there is total or near-total loss of kidney function and patients need dialysis or transplantation to stay alive. http://www.aakp.org

CKD may be the result of physical injury or a disease that damages the kidneys, such as diabetes or high blood pressure. When the kidneys are damaged, they do not remove wastes and extra water from the blood as well as they should.

Dysfunctional kidneys

Chronic kidney disease is a long-term condition where the kidneys don't work as well as they should. It's a common condition often associated with getting older. Anyone can get it, although it's more common in black people and people of south Asian origin.

Anemia develops when the kidneys fail to produce enough erythropoietin, EPO, the hormone that directs the bones to make red blood cells. Anemia tends to worsen as CKD progresses and can itself cause heart problems.


CKD patients become anaemic primarily due to impaired absorption of iron, blood loss into the gastrointestinal tract, and inadequate production of erythropoietin from the kidneys.

The management of patients not undergoing dialysis involves stepwise treatment with oral iron, intravenous iron, and erythropoietin stimulating agents (ESA’s).

Anemia is treated at first with iron supplementation, then intravenously if needed. Supplementation should be especially well tolerated, as it often is necessary over a longer time. Intravenous treatment is painful, inconvenient and expensive. It can also trigger oxidative stress.

Not many good alternatives

Different iron salts and other synthetic/chemical iron compounds have traditionally been used with mixed results. The uptake is only 2 - 4 % and there are often tolerance problems, especially after some time. However, since iron is essential for life the only alternatives are blood transfusions or intravenously given iron. Both have negative sides except being very costly and uncomfortable for the patient.

The clinical use of blood transfusion is associated with risks that can cause morbidity and mortality. Intravenous iron injections cause periods of exacerbation of oxidative stress in the circulation.

Anemia develops during the early stages of CKD and is common in patients with End Stage Renal Disease. Anemia is an important cause of left ventricular hypertrophy and congestive heart failure.

The solution

The absorption of heme iron is several times higher and the side-effects rate significantly lower than for non-heme oral iron.

Heme iron is absorbed through a separate pathway and does not have to be discontinued when intravenous treatment is started. This can allow for longer intervals between resource-heavy, inconvenient and painful injections. Oxidative stress is also avoided. Heme iron does not need to be discontinued during injection or EPO therapy like non-heme oral iron.

The OptiFer® series of iron food supplements are safe, efficient and very well tolerated, which is crucial for therapy success.

They give an optimal dose and can be used over longer periods with no change in efficacy or tolerance.

OptiFer® products compete favorably with the regular synthetic supplements.

Created By
Michael Collan, NutriCare Division, MediTec Group


Created with images by robtxgal - "1.12.10 Alan Hospital Kidney Stone" • DFAT photo library - "Medical professionals perform a specialist kidney operation for the first time in Tonga. The medical team are part of an AusAID-funded Pacific Islands Program (PIP) team visiting Tonga." • Municipalidad de Miraflores - "Campaña de despistaje de anemia en la Institución Educativa Manuel Bonilla. (5)" • oswaldoruiz - "dentist patient" • jarmoluk - "medications money cure"

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