Anemia iron-deficient

Although EPO deficiency is the primary cause of CKD anemia, iron deficiency is often present, and it is essential to assess and monitor the CKD patient s iron status (NKF-K/DOQI guidelines). Iron stores in patients with CKD should be maintained so that transferrin saturation (TSAT) is greater than 20% and serum ferritin is greater than 100 ng/mL (100 mcg/L or 225 pmol/L). If iron stores are not maintained appropriately, epoetin or darbepoetin will not be effective, and most CKD patients will require iron supplementation. Oral iron therapy can be used, but it is often ineffective, particularly in CKD patients on dialysis. Therefore, intravenous iron therapy is used extensively in these patients. Details of the pharmacology, pharmacokinetics, adverse effects, interactions, dose, and administration of erythropoietin and iron products have been discussed previously. 

Macrocytic anemias Megaloblastic anemias Vitamin B12 deficiency Folic acid deficiency anemia Microcytic hypochromic anemias Iron-deficiency anemia Genetic anomaly Sickle cell anemia Thalassemia... 

Mean cell volume Anemias Iron deficiency... 

Iron deficiency is usually due to blood loss, or more rarely to inadequate iron uptake. During pregnancy, increased demand can also cause iron deficiency states. In severe cases, reduced hemoglobin synthesis can lead to anemia ( iron-deficiency anemia ). In these patients, the erythrocytes are smaller and have less hemoglobin. As their membrane is also altered, they are prematurely eliminated in the spleen. 

Iron deficiency is the most common cause of chronic anemia. Like other forms of chronic anemia, iron deficiency anemia leads to pallor, fatigue, dizziness, exertional dyspnea, and other generalized symptoms of tissue hypoxia. The cardiovascular adaptations to chronic anemia—tachycardia, increased cardiac output, vasodilation—can worsen the condition of patients with underlying cardiovascular disease. 

The only clinical indication for the use of iron preparations is the treatment or prevention of iron deficiency anemia. Iron deficiency is commonly seen in populations with increased iron... 

Positive guaiac stool test and anemia (iron deficiency) from blood loss... 

Data from the US NHANES III (1988-1994) survey, which used a variety of indicators of iron status, showed that 9% of US toddlers were iron deficient and 3% had iron deficiency anemia. Eleven percent of adolescent females and women of reproductive age were iron deficient, and 3-5% of these women had iron deficiency anemia. Iron deficiency in the developed world is more common among low-income minorities. 

See also Anemia Iron-Deficiency Anemia. Folic Acid. Iodine Physiology, Dietary Sources and Requirements Deficiency Disorders. Supplementation Role of Micronutrient Supplementation Developed Countries. Vitamin A Biochemistry and Physiological Role. Zinc Physiology Deficiency in Developing Countries, Intervention Studies. 

See also Anemia Iron-Deficiency Anemia. Phytochemicals Classification and Occurrence Epidemiological Factors. Supplementation Dietary Supplements. 

Transferrin is essential for movement of iron and without it, as in genetic absence of transferrin, iron overload occurs in tissues. This hereditary atransferrinemia is coupled with iron-deficiency anemia. The iron overload in hereditary or acquired hemochromatosis results in fully saturated transferrin and is treated by phlebotomy (10). 

Thus, our attention should shift from the concern of potential adverse effects to the health benefits imparted by hormonal contraceptives. The use of oral contraceptives for at least 12 months reduces the risk of developing endometrial cancer by 50%. Furthermore, the risk of epithelial ovarian cancer in users of oral contraceptives is reduced by 40% compared with that on nonusers. This kind of protection is already seen after as little as 3-6 months of use. Oral contraceptives also decrease the incidence of ovarian cysts and fibrocystic breast disease. They reduce menstrual blood loss and thus the incidence of iron-deficiency anemia. A decreased incidence of pelvic inflammatory disease and ectopic pregnancies has been reported as well as an ameliorating effect on the clinical course of endometriosis. 

Anemia is a decrease in the number of red blood cells (RBCs), a decrease in die amount of hemoglobin in RBCs, or bodi a decrease in die number of RBCs and hemoglobin. When diere is an insufficient amount of hemoglobin to deliver oxygen to die tissues, anemia exists. There are various types and causes of anemia For example, anemia can be die result of blood loss, excessive destruction of RBCs, inadequate production of RBCs, and deficits in various nutrients, such as in iron deficiency anemia Once the type and cause have been identified, die primary health care provider selects a method of treatment. 

The anemias discussed in this chapter include iron deficiency anemia, anemia in patients witii chronic renal disease pernicious anemia, and anemia resulting from a folic acid deficiency. Table 45-1 defines these anemias. Drugp used in treatment of anemia are summarized in die Summary Drug Table Drugp Used in die Treatment of Anemia. 

Iron deficiency anemia is by far die most common type of anemia Iron is a component of hemoglobin, which is in RBCs. It is the iron in the hemoglobin of RBCs diat... 

Iron salts, such as ferrous sulfate or ferrous gluconate, are used in the treatment of iron deficiency anemia, which occurs when there is a loss of iron that is greater than the available iron stored in the body. Iron preparations act by elevating the serum iron concentration, which replenishes hemoglobin and depleted iron stores. 

Iron dextran is a parenteral iron that is also used for die treatment of iron deficiency anemia It is primarily used when the patient cannot take oral drugs or when the patient experiences gastrointestinal intolerance to oral iron administration. Other iron preparations, both oral and parenteral, used in the treatment of iron deficiency anemia can be found in the Summary Drug Table Dragp Used in the Treatment of Anemia... 

Iron deficiency Anemia characterized by an inadequate amount of iron in the body to produce hemoglobin... 

Taking the contraceptive hormones provides health benefits not related to contraception, such as regulating the menstrual cycle and decreased blood loss, and incidence of iron deficiency anemia, and dysmenorrhea Health benefits related to the inhibition of ovulation include a decrease in ovarian cysts and ectopic pregnancies. hi addition, there is a decrease in fibrocyctic breast disease, acute pelvic inflammatory disease endometrial cancer, ovarian cancer, maintenance of bone density, and symptoms related to endometriosis in women taking contraceptive hormones. Newer combination contraceptives such as norgestimate and ethinyl estradiol... 

Ferrous gluconate is the black dye used to color ripe olives. It is also used as an iron supplement to treat iron-deficiency anemia. 

A healthy adult human body contains about 3 g of iron, mostly as hemoglobin. Because about 1 mg is lost daily (in sweat, feces, and hair), and women lose about 20 mg in each menstrual cycle, iron must be ingested daily to maintain the balance. Iron deficiency, or anemia, results in reduced transport of oxygen to the brain and muscles, and an early symptom is chronic tiredness. 

Anemias, reductions in the number of red blood cells or of hemoglobin in the blood, can reflect impaired synthesis of hemoglobin (eg, in iron deficiency Chapter 51) or impaired production of erythrocytes (eg, in folic acid or vitamin Bjj deficiency Chapter 45). Diagnosis of anemias begins with spectroscopic measurement of blood hemoglobin levels. 

Inorganic iron is absorbed only in the (reduced) state, and for that reason the presence of reducing agents will enhance absorption. The most effective compound is vitamin C, and while intakes of 40-60 mg of vitamin C per day are more than adequate to meet requirements, an intake of 25-50 mg per meal will enhance iron absorption, especially when iron salts are used to treat iron deficiency anemia. Ethanol and fructose also enhance iron absorption. Heme iron from meat is absorbed separately and is considerably more available than inorganic iron. However, the absorption of both inorganic and heme iron is impaired by calcium—a glass of milk with a meal significantly reduces availabiUty. 

Attention to iron metabolism is particularly important in women for the reason mentioned above. Additionally, in pregnancy, allowances must be made for the growing fetus. Older people with poor dietary habits ( tea and toasters ) may develop iron deficiency. Iron deficiency anemia due to inadequate intake, inadequate utilization, or excessive loss of iron is one of the most prevalent conditions seen in medical practice. 

Transferrin binds iron, transporting it to sites where it is required. Ferritin provides an intracellular store of iron. Iron deficiency anemia is a very prevalent disorder. Hereditary hemochromatosis has been shown to be due to mutations in HFE, a gene encoding the protein HFE, which appeats to play an important role in absorption of iron. 

Iron deficiency anemia Inadequate intake or excessive loss of iron... 

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