Iron Deficiency Anemia

What is iron?

Iron is one of the minerals in the human body. It is one of the components of hemoglobin, the substance in red blood cells that helps blood carry oxygen throughout the body. If you do not have enough iron, your body cannot make enough hemoglobin.

What can contribute to iron deficiency?

- blood loss (caused by ulcers, some cancers, and other conditions)
- taking medications that interfere with the ability of the body to absorb iron
- kidney disease and end stage kidney disease
- certain diseases that prevent the absorption of iron
- cancer
- inflammatory bowel disease
- celiac disease
- taking an ESA (erythropoietin stimulating agent) a medication that helps make more red blood cells

Some symptoms of iron deficiency anemia can include, fatigue, paleness, difficulty breathing, dizziness, headache, and feeling cold.

Treatment of Iron Deficiency Anemia in Kidney Disease

Sometimes oral iron is recommended in a pill or capsule form. Often, side effects or oral iron, such as constipation, or poor absorption of oral iron may prevent people from correcting iron deficiency.

Intravenous iron is another way to treat iron deficiency. Iron is delivered into a person’s vein through a small needle. The procedure takes place in the kidney doctor’s office or an infusion clinic and the whole visit usually takes 30 minutes (in the doctor’s office) or it may take up to several hours (in an infusion clinic). You will receive iron injections over the course of weeks and complete lab work a few weeks after your iron treatment is completed to make check if the iron deficiency is corrected.

Most people don’t experience any side effects when receiving iron but possible side effects may include:

- dizziness or lightheadedness when getting up suddenly from a sitting position just after receiving iron
- nausea, but eating before receiving iron helps prevent this
- pain at injection site (as if you were getting blood drawn)
- occasionally staining of the skin at the injection site
- rash/itching
- low blood pressure or higher blood pressure just after receiving iron
- anaphylaxis (a severe reaction that can include difficulty breathing, itching, or a rash over the entire body)

When you should start to feel better depends on your particular situation. It may take several weeks to a month after you start your iron supplement before you start to feel better. Continue to watch your symptoms and take note of any possible new symptoms after you start your iron treatments. If you have any questions or concerns, talk to your kidney health care provider.

What about diet? Can I eat more foods higher in iron? Most providers agree that in kidney disease eating foods that are higher in iron in larger amounts may interfere with medications people take or can be higher in other nutrients not recommended with kidney disease. Please discuss any dietary questions with your kidney health care provider before changing your diet.

Laurie Pochik RN