{'fraction_non_alphanumeric': 0.020398701900788133, 'fraction_numerical': 0.004172461752433936, 'mean_word_length': 5.701863354037267, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
A Consensus on Current Issues and Controversies in Iron Management of Patients with Chronic Renal Failure

The objective of the consensus panel was to review existing literature on iron management in chronic renal failure (CRF) patients relative to the National Kidney Foundation–Dialysis Outcomes Quality Initiative (NKFDOQI) Anemia Guidelines in order to help guide clinicians in improving outcomes in CRF patients. Participants on the panel were leading nephrologists and research clinicians. The panel meeting was convened on October 5, 1997. The participants’ expertise includes physiology of renal disease and anemia, iron metabolism, management of anemia of chronic renal disease, and quality-of-life issues related to treatment. The group reviewed evidence in the existing literature on major topics: lessons learned during clinical trials and since recombinant human erythropoietin (rHuEPO) therapy became commercially available in 1989; iron physiology and metabolism; potential consequences of iron overload; effect of elevated iron levels on morbidity; use of oral iron versus intravenous (IV) iron; and riskbenefit ratio of IV iron. The strength of the evidence was reviewed in relation to the NKF-DOQI Anemia Guidelines. Potential barriers to implementing these guidelines were discussed and recommendations were made on the basis of the evidence presented. According to our current knowledge, no valid barriers exist to the implementation of the NKF-DOQI Anemia Guidelines. To date, no convincing evidence suggests that iron overload and tissue deposition, increased risk of infection or cardiovascular disease, or adverse events should dissuade physicians from following the guidelines. Several areas warrant additional research: studies of iron deposition in cardiac tissue in patients receiving only iron dextran; examination of the effect of repeated administration of IV iron dextran on tissue deposition in renal dialysis patients (through autopsy studies); and determination of whether correction of iron deficiency with IV iron can improve cognitive function and quality of life, independent of its effect on hematocrit or hemoglobin.