Combination Therapy for Iron Deficiency Anemia in CKD Patients

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Questions and Answers

What is the primary benefit of a combination of IV iron and erythropoiesis-stimulating agents (ESAs) for chronic kidney disease patients?

  • More rapid decline in renal function compared to standard care
  • Higher doses of ESAs required
  • Lower hemoglobin levels achieved
  • Reduction in the required dose of ESAs (correct)

Why is high-dose IV iron therapy not recommended for chronic kidney disease patients?

  • It causes iron deficiency
  • It leads to a rapid increase in hemoglobin levels
  • Concerns over iron toxicity and oxidative stress (correct)
  • It improves renal function

What limits the efficacy and tolerability of oral iron therapy in patients with chronic diseases?

  • Decreased inflammatory cytokines
  • Decreased iron absorption
  • Specific inflammatory condition at the site of inhibition of erythropoiesis (correct)
  • Improved utilization of iron

Why is a combination of erythropoiesis-stimulating agents (ESAs) and IV iron therapy more appropriate in certain cases?

<p>It avoids functional iron deficiency and accumulation in the reticuloendothelial system (B)</p> Signup and view all the answers

How does erythropoiesis-stimulating agents (ESAs) affect iron requirements in the body?

<p>Increases iron requirements (B)</p> Signup and view all the answers

Why is oral iron considered the frontline treatment for Iron Deficiency Anemia (IDA)?

<p>It can bypass the inflammatory condition in chronic diseases (B)</p> Signup and view all the answers

What was the result of administering iron and ascorbic acid to normal volunteers in a study?

<p>Significant increases in hemoglobin, hematocrit, and serum iron concentration (C)</p> Signup and view all the answers

In what cases is the heme oxygenase inhibitor SnMP particularly useful when used with iron?

<p>In cases where oral iron has failed (B)</p> Signup and view all the answers

What is the preferred form of iron therapy according to the 2008 NICE guidelines?

<p>Parenteral iron therapy (B)</p> Signup and view all the answers

Why may treatment with oral iron alone be ineffective and potentially detrimental in cases associated with chronic inflammatory states or infection?

<p>It generates oxygen-free radicals from iron loading of the reticuloendothelial system (A)</p> Signup and view all the answers

What do recent large randomized controlled trials suggest about the most effective regimens for iron replacement therapy?

<p>Combining oral and parenteral iron is the most effective (D)</p> Signup and view all the answers

What is the purpose of initially giving oral iron for a few weeks followed by parenteral iron in anemic patients?

<p>To assess and improve hemoglobin response if inadequate (C)</p> Signup and view all the answers

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