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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

Authoring team

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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