Intravenous Iron Therapy in Patients with Iron Deficiency Anemia: Dosing Considerations

Table 1

Potential role of iron therapy in management of anemia [12].

Condition	Expected hepcidin levels	Iron parameters	Iron therapy strategies	Potential hepcidin therapy
Absolute iron deficiency anemia (IDA)	Low	Low TSAT and ferritin	PO or IV if poorly tolerated or malabsorbed	No
Functional iron deficiency (ESA therapy, CKD)	Variable, depending on ±CKD	Low TSAT, variable ferritin	IV	Antagonist (if hepcidin levels are not low)
Iron sequestration (anemia of inflammation (AI))	High	Low TSAT, normal-to-elevated ferritin	IV	Antagonist
Mixed anemia (AI/IDA or AI/functional iron deficiency)	Variable	Low TSAT, low-to-normal ferritin	IV	Antagonist; (if hepcidin levels are not low)

TSAT = transferrin saturation; PO = oral; IV = intravenous; CKD = chronic kidney disease; ESA = erythropoiesis-stimulating agent.
Mixed anemia is a diagnosis of exclusion without a therapeutic trial of iron.
From [12].