摘要
鐵質缺乏是透析病人貧血的主要原因之一，成因在於病人腸道對鐵的吸收率和造血細胞對鐵的利用率皆降低。目前臨床指引對透析病人缺鐵的診斷及治療建議，主要仍是依據血清儲鐵蛋白（ferritin）濃度和運鐵蛋白飽和度（transferrin saturation）決定，亦即血清儲鐵蛋白＜ 500 ng/mL或運鐵蛋白飽和度＜ 30%即可考慮鐵劑補充治療。近來研究顯示，施打鐵劑將儲鐵蛋白維持在更高的數值還可能可以降低死亡率和心血管事件。與口服鐵劑相比，靜脈鐵劑治療可以更好地提升血紅素並減少紅血球生成素的劑量需求。在高分子量的iron dextran鐵劑退出市場後，現行靜脈鐵劑治療已經很少會引起嚴重過敏（anaphylaxis）反應。
並列摘要
Iron deficiency anemia is a common disorder in dialysis patients because of the poor enteral absorption of iron and the impaired utilization of iron for hematopoiesis. Current diagnostic and therapeutic guideline for iron deficiency anemia in dialysis patients is still based on the levels of serum ferritin and transferrin saturation, as ferritin ＜ 500 ng/ mL or transferrin saturation ＜ 30% is the general indication for iron supplementary therapy. According to recent studies, maintaining a higher ferritin level by intravenous iron may cause lower mortality and cardiovascular event. In comparison with oral iron supplementation, intravenous iron therapy is better in elevating hemoglobin levels and reducing erythropoiesis-stimulating agent requirement. Since the high molecule weight iron dextran is almost no longer on the market, current intravenous iron therapy rarely causes severe anaphylaxis.
延伸閱讀
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