Unmet needs about iron deficiency in peritoneal dialysis: a Delphi consensus panel

Background Anaemia and iron deficiency (ID) are common in chronic kidney disease (CKD) patients and related to outcomes. There is growing interest about the role of iron supplementation in CKD, particularly ferric carboxymaltose (FCM), also in relation to the use of erythropoiesis stimulating agents...

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Bibliographic Details
Published in:BMC nephrology 2022-10, Vol.23 (1), p.1-336, Article 336
Main Authors: Mazzaferro, Sandro, D'Alonzo, Silvia, Morosetti, Massimo
Format: Article
Language:English
Subjects:
Agreements
Anaemia
Anemia
Care and treatment
Chronic kidney disease
Chronic kidney failure
Complications and side effects
Continuous ambulatory peritoneal dialysis
Delphi method
Diagnosis
Dosage and administration
Economics
Erythropoiesis
Ferric carboxymaltose
Health aspects
Heart failure
Hemodialysis
Hemoglobin
Iron
Iron deficiency
Iron deficiency anemia
Kidney diseases
Laboratories
Nephrology
Nutrient deficiency
Patient outcomes
Peritoneal dialysis
Peritoneum
Pharmacoeconomics
Pharmacology
Quality of life
Questionnaires
Supplements
Surveys
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Summary:Background Anaemia and iron deficiency (ID) are common in chronic kidney disease (CKD) patients and related to outcomes. There is growing interest about the role of iron supplementation in CKD, particularly ferric carboxymaltose (FCM), also in relation to the use of erythropoiesis stimulating agents (ESAs). Despite a greater knowledge on ID management in patients receiving haemodialysis, a paucity of data exists about peritoneal dialysis (PD). Furthermore, the aim of this paper is to provide the results of a nationwide Italian survey about ID in PD using the Delphi method. Methods A list of 16 statements (48 items) was developed about four main topics: (1) approach to iron therapy in PD; (2) management experience about iron therapy in PD; (3) ESA and iron in PD; (4) pharmacoeconomic impact. Using the Delphi methodology, the survey was distributed online to 36 Italian nephrologists with expertise in PD, who rated their level of agreement with each item on a 5-point Likert scale. Consensus was predefined as more than 66% of the panel agreeing/disagreeing with any given statement. Results Twenty-five experts (70%) answered the survey. 35 items (73%) achieved a consensus (8 negative and 27 positive). In particular, the diagnosis of ID is widely known, but some doubts exist about how frequently test it. The use of I.V. iron seems to be routinary and can save money reducing the administration of ESAs. However, internal protocols are welcome. Conclusions Expert PD nephrologists know well the problem of ID and feel the necessity of shared protocols to optimize the iron therapy and consequently the use of ESAs. Keywords: Iron deficiency, Ferric carboxymaltose, Peritoneal dialysis, Chronic kidney disease, Anaemia
ISSN:1471-2369
1471-2369
DOI:10.1186/s12882-022-02969-3