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Monitoring of iron status and haemoglobin whilst on treatment for anaemia of CKD

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Monitoring of iron status and haemoglobin whilst on treatment for anaemia of chronic kidney disease (CKD):

  • iron levels
    • people with anaemia of CKD should not have iron levels checked earlier than 1 week after receiving intravenous iron
      • length of time to monitoring of iron status is dependent on the product used and the amount of iron given
    • routine monitoring of iron stores to prevent iron overload using serum ferritin should be at intervals of 1-3months

  • monitoring haemoglobin levels
    • every 2-4 weeks in the induction phase of erythropoietin stimulating agent (ESA) therapy
    • every 1-3 months in the maintenance phase of ESA therapy
    • more actively after an ESA dose adjustment

ESAs: dose and frequency

  • When correcting anaemia of CKD, the dose and frequency of ESA should be:

    • determined by the duration of action and route of administration of the ESA

    • adjusted to keep the rate of Hb increase between 10 and 20 g/litre/month

Notes:

  • in people treated with iron, serum ferritin levels should not rise above 800 micrograms/litre. In order to prevent this, review the dose of iron when serum ferritin levels reach 500micrograms/litre

Reference:

NICE (June 2015). Anaemia management in people with chronic kidney disease


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