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Treatment of iron deficiency in hemodialysis patients

Jeffrey S Berns, MD
Section Editor
Thomas A Golper, MD
Deputy Editor
Alice M Sheridan, MD


Dialysis patients are often iron deficient due to gastrointestinal bleeding, blood drawing, operations, and the dialysis treatment itself. Hemodialysis patients lose an average of 1 to 2 g of iron per year [1].

Adequate iron stores are essential for achieving optimal hemoglobin (Hb) levels and maximum benefit from erythropoiesis-stimulating agents (ESAs). Decreased iron stores or decreased availability of iron are the most common reasons for resistance to the effect of these agents.

This topic reviews screening for iron deficiency, the indications for iron therapy, and options for treatment of iron deficiency among dialysis patients. The evaluation of anemia among hemodialysis patients is discussed elsewhere. (See "Treatment of anemia in hemodialysis patients", section on 'Screening'.)

The treatment of iron deficiency in nondialysis patients with chronic kidney disease (CKD) and in peritoneal dialysis patients are discussed elsewhere. (See "Treatment of iron deficiency in nondialysis chronic kidney disease (CKD) patients" and "Treatment of iron deficiency in peritoneal dialysis patients".)

Indications for treatment with ESAs are discussed separately. (See "Hyporesponse to erythropoiesis-stimulating agents (ESAs) in chronic kidney disease" and "Treatment of anemia in hemodialysis patients" and "Treatment of anemia in nondialysis chronic kidney disease".)

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Literature review current through: Nov 2017. | This topic last updated: Nov 28, 2016.
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