Oral iron in the nephrology setting

Why is oral iron rarely sufficient in the nephrology
setting
?

There are several reasons. First of all, these patients are not simply iron deficient patients. They are patients who have anaemia of chronic illness or chronic inflammation and are unable to access their iron.

Although oral iron, even with decent absorption, which is rarely present in this patient population, can allow iron to get into the circulation, there is too much competition from other inflammatory mediators making it nearly worthless.

Further, it is toxic. It interferes with absorption, it interferes with gut motility, it causes constipation, it makes the stool more tenacious and leaves patients with a metallic taste.

So we are dealing with a group of people with a host of side effects anyway, and the combination of lack of efficacy and toxicity makes oral iron virtually worthless in that patient population, says Dr. Michael Auerbach, Clinical Professor of Medicine, Georgetown University School of Medicine. Currently in Private Practice in Baltimore, USA.