Anaemia and iron

Question 1

How much iron to increase Hb?

How much iron stored need to be replenished?

How much PC equivalent by giving 1 vial of monofer (10mL = 1000 mg)

Answer 1

500 mg increases 2-3 g/dL over 1-2 months.
initial increments expected at 1-2 weeks.

8mg Iron = 1 ng/mL of ferritin
1000 mg iron = 125 ng/L of Ferritin

1 vial of monofer (10mL = 1000 mg)
= 4 PC increase (likely over 21 days)

Munoz 2017: DOI: 10.2450/2017.0113-17
(taken from product leaflet monofer)

Question 2

Define Anaemia and Iron

absolute IDA
relative IDA

Answer 2

Absolute ID: Ferritin <100 ng/mL AND TSAT < 20% [Kdigo]

Question 3

When to give Iron

In CKD on ESA

Answer 3

CKD nd and NOT on ESA:

• TSAT <25 % and ferritin is < 200 ng/mL

HD pts NOT on ESA:

• TSAT < 25 % and ferritin < 200 ng/mL

CKD/HD on ESA:

• TSAT ≤ 30 % and ferritin ≤ 500 ng/mL

Munoz 2017: DOI: 10.2450/2017.0113-17
?KDIGO