Treatment of iron deficiency in peritoneal dialysis patients
- Jeffrey S Berns, MD
Jeffrey S Berns, MD
- Editor-in-Chief — Nephrology
- Section Editor — Dialysis
- Professor of Medicine
- Perelman School of Medicine at the University of Pennsylvania
Anemia is common among peritoneal dialysis patients. Anemia underlies many of the symptoms associated with reduced kidney function and is associated with increased mortality and hospitalizations [1-4]. Iron deficiency is a common reversible cause of anemia among peritoneal dialysis patients.
This topic reviews screening for and treatment of iron deficiency among peritoneal dialysis patients. Iron deficiency in hemodialysis patients and in nondialysis chronic kidney disease (CKD) patients is discussed elsewhere. (See "Treatment of iron deficiency in hemodialysis patients" and "Diagnosis of iron deficiency in chronic kidney disease".)
Indications for treatment with erythropoiesis-stimulating agents (ESAs) are discussed separately. (See "Treatment of anemia in peritoneal dialysis patients".)
EPIDEMIOLOGY AND CAUSE
Iron deficiency is more common among peritoneal dialysis patients compared with the nondialysis population. In the United States, among 17,842 patients undergoing peritoneal dialysis in 2011, 36.5 percent received intravenous (IV) iron . By comparison, iron deficiency is present in 1 to 12 percent of individuals worldwide and in the United States. (See "Causes and diagnosis of iron deficiency and iron deficiency anemia in adults", section on 'Epidemiology'.)
Iron deficiency is less common among peritoneal dialysis patients compared with hemodialysis patients. In the Medicare study cited above, 36.6 percent of peritoneal dialysis patients received IV iron compared with 74.5 percent of hemodialysis patients .
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