Service ICAR, Service de néphrologie, GHU Pitié-Salpêtrière, Paris
- Key words: anemia, chronic renal insufficiency, erythropoiesis stimulating agent (ESA), iron deficiency, IV iron complexes
- DOI : 10.1684/jpc.2011.0195
- Page(s) : 229-34
- Published in: 2011
Anemia is frequent in nephrology and can be observed in chronic renal insufficiency patients when the glomerular filtration rate falls under 60 mL/min/1.73m
2. The main causes of anemia in these patients are a deficit of endogenous erythropoietin EPO production by the kidney and iron deficiency. Thus, the management of anemia includes first the diagnosis of chronic renal insufficiency, and then the exploration of anemia, with the iron deficiency according to the available recommendations. Treatments include the correction of the iron deficiency with IV iron complexes and the use of ESA (erythropoiesis stimulating agent) in order to reach the recommended target of hemoglobinemia, ferritinemia and transferrin saturation coefficient. Therefore, ESA and/or IV iron complexes is the basement of the therapeutic strategy, but these products are not equivalent to each other in terms of efficacy, safety and handling.