Integrated Care of Anemia in Chronic Kidney Disease Patients: Concepts in Intravenous Iron Management: Part Two

Iron deficiency anemia (IDA), as a result of chronic kidney disease (CKD), has become a worldwide public health issue with increasing prevalence in the United States. An awareness of clinical practice guidelines and safety profiles of intravenous (IV) iron products enables health care professionals to improve patient outcomes in the treatment of CKD-associated IDA. Selection of appropriate IV iron therapy in all patient care settings may encompass considerations such as product premedication and test-dose requirements, preparation and administration, monitoring parameters, safety concerns, cost of care, patient education, and patient self-administration when appropriate. More specifically, a medication use process (prescribing, preparing, dispensing, administering, monitoring, and specific outcomes) should be applied by health systems during the evaluation process to achieve optimal patient outcomes. This performance improvement process serves to promote appropriate medication therapy, improve patient safety, control costs of therapy, stimulate improvements in processes, and provide educational opportunities. This article, the second of a two-part series, describes elements of the medication use process for care of CKD patients with IDA, whereas the preceding article in this series discusses the optimization of IV iron therapy in CKD patients and compares the four parenteral iron agents available on the market.