Date Published: 01/06/2006

Iron deficiency toolkit - irontherapy.org

ITO

This toolkit aims at assisting you in diagnosing and treating iron deficiency in your patients.

The tools are as follows:

• Figure 1: Mechanisms that intervene in the uptake, intracellular distribution and transport of iron to cell populations
• Table 1: Iron Management in Patients with CKD
• Table 2: Characteristics of functional iron deficiency

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Figure 1: Cellular iron uptake: mechanisms that intervene in the uptake,
intracellular distribution and transport of iron to cell populations

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Iron Parameters to reach and maintain Hb > 11 g/dL; sufficient iron should be administered to reach the following targets, according to the European Best Practice Guidelines. Serum ferritin (SF) > 100 ?g/L Hypochromic red blood cells (HRC) < 10%, or Transferrin saturation (TSAT) > 20%, or Reticulocyte Hb content (CHr) > 29 pg/cell

Table 1: Iron Management in Patients with CKD: Targets to Maintain Hemoglobin (Hb) > 11 g/dL

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Characteristics of functional iron deficiency, which is a failure to deliver iron quick enough to proliferating erythroblasts: Inadequate hemoglobin (Hb) response to recombinant human erythropoietin (rHuEPO) Transferrin saturation (TSAT) often < 20% but can vary Percentage of hypochromic red cells > 5-10% Reduced MCV and MCHC (in severe cases) Serum ferritin (SF) may be normal of raised Functional iron deficiency should respond to intravenous iron

Table 2: Characteristics of functional iron deficiency

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Figure 2: Pathways of iron uptake (top), traffic and export, depicted in a generic cell

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