An Indistinct Balance The Safety and Efficacy of Parenteral Iron Therapy

[摘要] The National Kidney Foundation Dialysis Quality Initiatives (NKF-DOQI) Anemia Work Group developed clinical practice guidelines (1) that aimed to achieve a target hemoglobin level of 11 to 12 g/dl at the lowest cost by optimizing the erythron response to recombinant human erythropoietin (epoetin). Despite the use of epoetin to manage the anemia of chronic renal failure (CRF) (2,3,4,5,6), many patients remain at hematocrits below currently recommended levels. Persistence of suboptimal hematocrit levels despite administration of seemingly adequate doses of epoetin signifies an inadequate response to the agent. The most common cause for such erythropoietin resistance is an inadequate supply of iron to the bone marrow to sustain enhanced erythropoiesis (7,8,9,10,11,12,13).

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome