Addressing The Ongoing Clinical Debate: Implications of Iron Therapy

Learn With the Experts: A Kidney Learning System (KLS) Program
Sponsored by the National Kidney Foundation / Supported by an educational grant from Watson Nephrology
Access to this KLS activity is free but requires a login (username) and password. The activity is hosted by HDCN, and for current HDCN users, your existing login and password should be given. If you are not an HDCN user, please register at this link and select a username and password.
Clinical Relevance of K/DOQI Guidelines for Management of Anemia of Chronic Kidney Disease
John Stivelman, MD
Iron Therapy: Risks vs Benefits
David G. Warnock, MD.
Product Characteristics: What to Consider When Selecting an Iron Therapy
Daniel Coyne, MD.
Panel Discussion
J. Stivelman, D. Warnock, D. Coyne.

Upon completion of the program, participants should be able to:
  • Discuss the clinical relevance of the K/DOQI guidelines
  • Discuss the need for IV iron therapy in hemodialysis patients
  • Discuss the relative and specific risks of available IV iron preparations
  • Discuss the product characteristics to consider when selecting an iron therapy
John Stivelman, MD
Northwest Kidney Centers
University of Washington
Seattle, Washington

David G. Warnock, MD
University of Alabama
Birmingham, Alabama

Daniel Coyne, MD
Chromally American Kidney Center
Washington University School of Medicine
St. Louis, Misouri

For Physicians, this learning activity is accredited for up to 2.0 CME credit hours by the National Kidney Foundation.

For nurses and dialysis technicians, this learning activity is accredited for 1.9 CE credit hours.
Date of Release: November, 2003
CME Credit Eligible Through: April, 2005
Target Audiences: CME: Nephrologists, nephrology fellows, internists
CE: Nurses and dialysis technicians
Method of Participation: Listen to the talk, read the PubMed abstracts linked to data slides and talk references, complete the post-test and evaluation.

It is estimated that 20 million people have chronic kidney disease (CKD). It is well established that anemia usually develops during the course of chronic kidney disease and is nearly universal in people with kidney failure. Anemia is associated with worse outcomes in CKD. Measures used to assess anemia and its causes include hemoglobin, hematocrit and iron stores. Although erythropoietin deficiency is the primary cause of anemia in CKD, adequate iron is also essential for hemoglobin formation. Overall outcomes of CKD patients could be improved significantly by appropriate assessment and treatment of anemia. There is a growing need for awareness and understanding of issues related to iron therapy in managing anemia in CKD by health care providers to improve patient outcomes on an ongoing basis.

Physician Accreditation
The National Kidney Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. This activity has been approved for AMA PRA Category 1 credit.

The National Kidney Foundation designates this educational activity for a maximum of 2.0 hours of Category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

Nursing Accreditation
Provider approved by the California Board of Registered Nursing, Provider #CEP13475, for 1.9 contact hours.

The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) Clinical Practice Guidelines for Anemia in Chronic Kidney Disease Update 2000 are based upon the best information available at the time of publication. They are designed to provide information and assist in decision-making. They are not intended to define a standard of care and should not be construed as doing so, nor should they be interpreted as prescribing an exclusive course of management.

Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of these guidelines is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation.

The views presented herein are those of the faculty and not necessarily those of the National Kidney Foundation, HDCN or Watson Pharmaceuticals, Inc. This material is prepared based upon a review of multiple sources of information, but is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials about the subject matter before relying solely upon the information contained within this material.

The National Kidney Foundation as well as HDCN have conflict of interest policies that requires course faculty to disclose any real or apparent commercial financial affiliations related to the content of their presentations/materials. It is not assumed that these financial interests or affiliations will have an adverse impact on faculty presentations; they are simply noted here to fully inform participants.

Dr. Stivelman has received grants/research support from Amgen, Watson Nephrology, Abbot Laboratories, Shire, and In-Line Diagnostics and is a consultant and Speaker Bureau participant for Amgen and Watson Nephrology.

Dr. Warnock has received grants/research support from and is a consultant and Speaker Bureau participant for Watson Nephrology.

Dr. Coyne has received grants/research support from and is a consultant and Speaker Bureau participant for Watson Pharmaceuticals, Inc.

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The National Kidney Foundation and HDCN do not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

To complete this educational activity, the user will need Windows or Macintosh operating software, a connection to the internet with a 28.8 kbps MODEM or better. The computer should have an audio card with speakers. An audio player, either the Windows Media Player from Microsoft or the Real Player from Real Media ( is required and either can be downloaded for free per instructions on the individual lecture pages. Acrobat Reader is required to print the CME or CE certificate, and this can be download free from

For any questions concerning this activity please send an email to or call HDCN at 630-325-3276.