Irondeficiency leads to inefficient erythropoiesis and is a commoncause of ESA resistance (22).
Treatment of iron deficiency istherefore an essential component of appropriate anemia managementin HD patients.
Intravenous iron therapy replaces ironlost during the HD procedure, enables efficient erythropoiesis,and ameliorates ESA resistance in the setting of iron deficiency,thereby optimizing the use and effects of ESA therapy (7,23–26).
The Kidney Disease Outcomes Quality Initiative anemia guidelinesrecommend IV administration as the preferred route ofiron delivery in HD patients on ESA therapy and recommendthat the goal of therapy should be to achieve and maintainTSAT _20%, CHr _29 pg/cell, and serum ferritin _200 ng/ml(9). Consequently, most HD patients in the United States receiveIV iron to treat iron-deficiency anemia.