Anemia Management and Iron Monitoring in Patients Treated with Erythropoiesis-stimulating Agents

Abstract

Renal anemia is a frequent complication of impaired renal function. It has many negative consequences on quality of life, exercise capacity, cardio-vascular events and mortality. The treatment of renal anemia has considerably been improved and facilitated by the use of erythropoiesis-stimulating agents (ESA). Such a treatment often leads to functional iron deficiency, which is the main cause of resistance to ESA therapy. It is of clinical and pharmaco-economical importance to identify functional iron deficiency. The available biological parameters are ferritin (FRT), transferrin saturation (TSAT), reticulocyte hemoglobin content (CHr), percentage of hypochromic red blood cells (%HYPO), percentage of hypochromic mature erythrocytes (%HYPOm), soluble transferrin receptors (sTfR) and, maybe, hepcidin. The more reliable parameters to predict the response to iron supplementation seem to be CHr, %HYPO and %HYPOm.

Keywords: Anemia, erythropoiesis, iron

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