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</p> Signup and view all the answers

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

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

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