Iron, Anemia, and You!
Introduction
Anemia is a major problem in people on dialysis. You need iron to help your body make healthy red blood cells (RBCs). Keeping anemia under control will help you feel your best.
What Is Anemia?
- RBCs in your blood carry oxygen to all parts of your body
- Anemia means not enough RBCs and, therefore, not enough oxygen for your body to function at its best
- Anemia may lead to:
- — Tiredness
- — Sensitivity to cold
- — Shortness of breath
- — Paleness
- — Dizziness or fainting
- — Loss of concentration
- — Chest pain
The Kidneys and Anemia
- Healthy kidneys help the body make enough RBCs by making a hormone called erythropoietin
- RBCs are formed in bone marrow with the help of this hormone, iron, certain vitamins, and protein
What Causes Anemia?
- Blood loss: if you lose blood, you lose RBCs and iron, too
- Not enough erythropoietin hormone: with chronic kidney disease, an outside source of erythropoietin may be needed
- Not enough iron: with chronic kidney disease, your body may need more iron than you get from food and oral iron supplements
Epogen® (Epoetin alfa)
- Epogen® is a man-made form of the hormone erythropoietin
- Epogen® tells your body to make RBCs
- For Epogen® to work best, you also need enough iron and certain vitamins
What Is Iron and Why Is It So Important?
Iron is an essential element in your RBCs. It carries oxygen throughout your body. IRON—you need just the right amount!
Your doctor and healthcare team know when to give iron:
- Blood tests tell your doctor how healthy your RBCs are and if you have enough of them
- Blood tests show if you have enough iron to make healthy RBCs
Hemoglobin and Hematocrit
- Hemoglobin is the part of the RBC that contains oxygen. Hemoglobin should be between 11 and 12 g/dL in most dialysis patients
- Hematocrit tells how many RBCs are in a specific amount of blood. Hematocrit should be between 33% and 36% in most dialysis patients
Ferritin and Transferrin
- Ferritin shows the amount of iron in "storage." Ferritin should be between 100 and 800 ng/mL
- Transferrin shows the amount of iron "available" to make RBCs. Transferrin saturation should be between 20% and 50%
What Can Be Done to Prevent or Control Anemia?
Anemia is treated with:
- Epogen® (man-made erythropoietin hormone)
- Iron (oral or intravenous)
- Vitamins
- Eating a protein-rich diet
Oral Iron
Your doctor may first prescribe oral iron. Oral iron is usually given 1 to 3 times a day between meals.
Please remember:
- Take oral iron 1 hour before or 2 hours after a meal
- Do not take with antacids
- Do not take with phosphate binders
- If you get constipated, ask your doctor about taking stool softeners
IV Iron
If you are not able to reach a good RBC count with oral iron, or if you cannot tolerate oral iron, your doctor may prescribe intravenous (IV) iron. IV iron is injected into your bloodstream.
The Food and Drug Administration has approved 3 types of IV iron products for use in the United States. These are:
- Iron sucrose injection, USP
- Iron dextran injection, USP
- Sodium ferric gluconate complex in sucrose injection (also known as iron gluconate)
Some of the differences in IV iron products are:
- How fast they work
- Whether or not a test dose is needed
- Types of side effects
- Size of the dose given
- Their approved indications
Outcomes
Understanding anemia and how it is treated will help you take good care of yourself. Remember:
- Anemia is common when you have chronic kidney disease
- Your healthcare team will determine which treatment is best for you
- If you have any questions, ask a member of your healthcare team
Venofer® (iron sucrose injection, USP)
- An injectable IV iron
- Manufactured by American Regent, Inc.
- Ask your doctor if Venofer® is the right IV iron for you
Epogen® is a registered trademark of Amgen, Inc.
IMPORTANT SAFETY INFORMATION
Venofer® (iron sucrose injection, USP) is contraindicated in patients with evidence of iron overload, in patients with known hypersensitivity to Venofer® or any of its inactive components, and in patients with anemia not caused by iron deficiency. Hypersensitivity reactions have been reported with injectable iron products. Hypotension has been reported frequently in patients receiving intravenous iron. Hypotension following administration of Venofer® may be related to rate of administration and total dose delivered. In multidose efficacy studies (N=231), the most frequent adverse events, whether or not related to Venofer® administration, were hypotension, cramps/leg cramps, nausea, headache, vomiting, and diarrhea. In postmarketing safety studies (N=1051), the most frequent adverse events reported (>1%) were congestive heart failure, sepsis, and taste perversion.
Please see Full Prescribing Information.
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