Singh Neeraj, Agarwal Anil K
Division of Nephrology, The Ohio State University, Columbus, OH 43210, USA.
Clin Nephrol. 2012 Mar;77(3):188-94. doi: 10.5414/cn107266.
Iron deficiency is a common cause of anemia in patients with end stage renal disease (ESRD). Intravenous iron administration, especially in those requiring treatment with erythropoiesis stimulating agents (ESA) is an essential component of the management of anemia in ESRD patients. Iron improves hemoglobin, reduces ESA dose requirement and also has nonerythropoietic effects including improvement in physical performance, cognition and amelioration of restless leg syndrome. However, iron can promote oxidative stress, cause endothelial dysfunction, inflammation and tissue injury, and has a potential to cause progression of both CKD and cardiovascular disease. In this review, we discuss the benefits and risks associated with i.v. iron and the practical aspects of iron administration that can minimize the complications related to iron therapy in ESRD.
缺铁是终末期肾病（ESRD）患者贫血的常见原因。静脉补铁，尤其是在那些需要使用促红细胞生成素（ESA）进行治疗的患者中，是ESRD患者贫血管理的重要组成部分。铁可提高血红蛋白水平，降低ESA剂量需求，还具有非促红细胞生成作用，包括改善身体机能、认知功能以及缓解不安腿综合征。然而，铁可促进氧化应激，导致内皮功能障碍、炎症和组织损伤，并有可能导致慢性肾脏病（CKD）和心血管疾病的进展。在本综述中，我们讨论了静脉补铁的益处和风险，以及铁剂给药的实际问题，这些问题可将ESRD患者铁治疗相关并发症降至最低。
