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  Iron Deficiency
  Chronic Renal Failure
  Managing Iron Deficiency Anemia
  Key Learnings

Glossary 

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Anaphylaxis (AN-a-fy-LAK-sis): a manifestation of immediate hypersensitivity resulting from exposure of a sensitized individual to a specific antigen (such as to foreign proteins or drugs). Anaphylactic shock is often a severe, and sometimes fatal, systemic reaction in a susceptible individual characterized especially by respiratory symptoms, fainting, itching, and hives. Treatment of anaphylactic shock may require cardiopulmonary resuscitation

Anemia (uh-NEE-mee-uh): any condition in which the number of red blood cells, the amount of hemoglobin, and the volume of packed red blood cells in the blood are lower than normal levels

Anemia of chronic disease: condition seen in a wide range of chronic disorders in which iron utilization is impaired, resulting in low levels of iron as hemoglobin despite normal or high levels of stored iron

Aqueous (A-kwe-us): containing water

Blood urea nitrogen (yoo-REE-uh NY-truh-jen): a waste product in the blood that comes from the breakdown of food protein and is removed by the kidneys. As kidney function decreases, the blood urea nitrogen level increases

CKD:  Chronic Kidney Disease (see Chronic Renal Failure)

CRF:  Chronic Renal Failure (see Chronic Renal Failure)

Catalyze (CAT-uh-lies): to accelerate a chemical reaction without being consumed or permanently changed

Catheter (CATH-eh-ter): tubular instrument that allows passing of fluid from or into a body cavity

Chronic renal failure (or chronic kidney failure, or chronic kidney disease): slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease

Creatinine clearance (kree-AT-ih-neen): test of renal function based on the rate at which ingested creatinine is filtered through the renal glomeruli

Cytochrome (SITE-oh-chrome): iron-containing protein with the principal function of electron transport within cells

Delayed release: oral formulation designed to maximize the release of the active substance in the higher pH environment of the small intestine, where it is best absorbed

Dextran (DEX-tran): a glucose polymer, available in various molecular weights

Diabetes (dy-uh-BEE-teez): diabetes mellitus; a metabolic disease in which deficient insulin leads to decreased carbohydrate utilization and enhanced utilization of lipids and proteins

Diabetic nephropathy (dy-uh-BET-ic nef-ROP-ith-ee): kidney disease and resultant kidney function impairment due to the long-standing effects of diabetes on the glomeruli. Features include increased urine protein and declining kidney function. Severe diabetic nephropathy can lead to kidney failure and end-stage renal disease

Dialysate (di-AL-ih-sayt): cleansing solution, containing salts and glucose, used in dialysis therapy

Dialysis (dy-AL-ih-sis): form of renal replacement therapy in which blood is passed across a semipermeable membrane to remove waste products and excess fluid

Dialyzer (DY-uh-LY-zehr): part of the hemodialysis machine that holds the dialysate in one section and the patient’s blood in another

Elimination half-life: the time it takes for the amount of drug in the body to decrease by one half

Elixir (ee-LIK-sehr): clear, sweetened liquid, sometimes containing medicinal agents, intended for oral use

Epidermal (ep-ih-DER-mahl): relating to the superficial portion of the skin

Epoetin (ee-POH-eh-tin); also recombinant human erythropoietin (ree-KAHM-bin-ant eh-rith-roh-POY-eh-tin): a glycoprotein manufactured by recombinant DNA technology that stimulates red-blood-cell production. It is produced by mammalian cells into which the human erythropoietin gene has been introduced

Erythema (er-ih-THEE-mah): redness of the skin due to capillary dilatation; flush

Erythrocytes (eh-RITH-roh-SITES): mature red blood cells

Erythroid cells (eh-RITH-royd): cells in the bone marrow that give rise to red blood cells

Erythron (ER-i-thron): the total mass of circulating red blood cells and the part of the hematopoietic tissue from which they are derived

Erythropoiesis (eh-RITH-roh-poy-EE-sis): formation of new red blood cells

Erythropoietin (eh-rith-roh-POY-eh-tin): a protein produced by the kidney that enhances the formation of red blood cells

Ferritin (FER-uh-tin): an iron-protein complex found in the intestinal mucosa, spleen, bone marrow, reticulocytes, and liver. It regulates iron storage and transport

Folate: (FOH-late): salt of folic acid, a part of the vitamin B complex necessary for red-blood-cell production

Free radical: an atom or electrically neutral molecule that has one or more unpaired electrons in its outer orbit. Free radicals are unstable and react quickly with other atoms and molecules. As a result, they can damage living tissues

Functional iron: pool of iron represented by iron that is a constituent of cell components such as hemoglobin

Functional iron deficiency: iron deficiency that develops during treatment with epoetin, a result of the failure of reticuloendothelial cells to release stores of iron fast enough to meet erythroid cell demand for iron during stimulated red-blood-cell production

Glomerular filtration rate (glow-MEHR-yoo-lar): rate at which a given compound passes through the glomerulus in a given time (usually per minute). If a compound is not reabsorbed or excreted, the amount of compound found in the urine in the given time is a measure of the glomerular filtration rate

Glomerulonephritis (glow-MEHR-yoo-loh-ne-FRY-tiss): nephritis marked by inflammation of the capillaries of the renal glomeruli

Glomerulus (glow-MEHR-yoo-lus): a tuft formed of capillaries at the beginning of each nephric tube in the kidney

HDD-CKD: Hemodialysis dependent - chronic kidney disease

Hematinic agents (hee-mah-TIN-ik): agents that improve the quality of blood by increasing the red-blood-cell count and hemoglobin concentration

Hematocrit (heh-MAH-toe-krit): percentage of the volume of a blood sample occupied by cells

Heme (HEEM): the deep red, nonprotein, iron-containing pigment that is a component of hemoglobin and myoglobin

Hemodialysis (HEE-moh-dy-AL-ih-sis): see dialysis

Hemoglobin (HEE-moh-GLOH-bin): the oxygen-carrying pigment in red blood cells

Hemolytic (HEE-moh-LIT-ic): associated with the destruction of red blood cells

Hemosiderin (hee-moh-SID-er-in): an insoluble protein complex found in most tissues in the form of granules believed to be aggregates of ferritin but with a much higher iron content

Historical control group: comparison group consisting of a population and corresponding data from past clinical experience

Hypochromic (hy-poh-KROH-mik): cells deficient in hemoglobin and iron content

Intramuscular (IN-truh-mus-cue-lahr): into the muscle

Iron deficiency: depletion of iron stores to the degree that red-blood-cell production is impaired

Iron deficiency anemia: anemia accompanied by indicators of low iron status

Mean corpuscular volume (kor-PUS-kyoo-lahr): a measure of the average volume of red blood cells

Metabolic acidosis (as-eh-DOE-sis): decreased pH and bicarbonate concentration in body fluids caused by accumulation of acids

Microcytic: cells that are reduced in size relative to normal values

Myoglobin (MY-oh-GLOH-bin): the oxygen-transporting and storage protein of muscle, resembling blood hemoglobin in function

NDD-CKD: Non-dialysis dependent - chronic kidney disease

Nonheme iron (NON-heem): iron not bound in a porphyrin ring like that of heme

Open-label study: study in which subjects and investigators know which agent is being administered to each group during the trial period

Paresthesia (PAHR-ess-thee-see-uh): abnormal sensation, such as tingling or burning

Peritoneal membrane (per-ih-toh-NEE-ahl): natural membrane lining the peritoneal (abdominal) cavity

Pharmacokinetics (FAHR-mah-ko-ki-NET-iks): movement of drugs within biological systems; includes measures of drug absorption, distribution, metabolism, and excretion

Polynuclear (PAHL-ee-new-clee-her): having two or more nuclei

Prednisone (PRED-nih-zone): asteroid drug with a potent anti-inflammatory effect

Proerythroblasts (proh-eh-RITH-roh-blasts): stem cells for blood-cellular elements that give rise to erythroblasts; proerythroblasts are also referred to as pronormoblasts

Protoporphyrin (pro-toh-POUR-fir-in): molecule that combines with iron during the process of hemoglobin synthesis

Pruritus (proo-RY-tuss): itching

Recombinant (ree-KAHM-bin-ant): manufactured by inserting the DNA of a desired gene into the DNA of a bacterium, which then reproduces itself, yielding more of the desired gene

Respiratory enzymes (EN-zimes): enzymes within cells that convert complex substances to carbon dioxide and water, transferring the removed electrons to oxygen

Reticulocytes (reh-TIK-you-low-SITES):immature red blood cells; first red blood cells to enter the circulation during erythropoiesis

Reticuloendothelial cells (reh-TIK-you-low-EN-dough-THEE-lee-al): specialized cells in liver, spleen, and bone marrow that take up and store inert particles

Reticuloendothelial system (reh-TIK-you-low-EN-dough-THEE-lee-al): a collection of cells arising from stem cells in the bone marrow as well as specialized cells in the spleen, liver, and lymph nodes

Semipermeable (sem-ee-PER-mee-uh-bul): allowing selected substances to pass through

Serum creatinine (kree-AT-ih-neen): blood levels of a waste product created by breakdown of muscle during activity

Serum ferritin (FER-I-tin): soluble form of iron-protein complex, containing up to 23% of iron, in circulation

Sickle cell anemia: inherited disorder leading to production of crescent (sickle)-shaped erythrocytes and accelerated red-blood-cell destruction

Sideroblastic anemia (SID-er-oh-BLAS-tik): enzyme disorder in which the body is unable to incorporate iron into hemoglobin regardless of iron supply

Stem cells: unspecialized cells that give rise to differentiated cells in bone marrow

Total clearance: measure of how rapidly the organ(s) of elimination clear(s) a drug from the plasma

Total dose infusion of iron: a full therapeutic dose of iron given by single IV infusion. Dosage amount is calculated according to a specific formula, taking into account patient body weight and hemoglobin levels

Transferrin (trans-FER-in):iron-transporting protein that circulates in the blood

Transferrin saturation (trans-FER-in satch-uh-RAY-shun): the amount of protein-bound iron in circulation

Transfusion (tranz-FYOO-zhun): transfer of blood or blood components from one individual to another

Uremia (yoo-REE-mee-uh): buildup of excess water and waste products in the body due to renal failure

Urticaria (UR-tih-CAR-ee-a): hives

Vitamin B12: a complex, cobalt-containing compound that occurs especially in liver and is essential to normal blood formation, neural function, and growth

Volume of distribution: a measure that relates the amount of drug in the body to the concentration in the blood

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