Date of publication: October 1, 2014

Medical Education

Module 1: Physiology of iron metabolism

Iron deficiency (ID) is one of the most common nutritional deficiencies in the world and a major cause of anaemia.((1) In addition, ID alone or with anaemia – a condition known as iron deficiency anaemia (IDA) – is prevalent in patients with chronic kidney disease (CKD).(2,3) Despite its frequency, ID/IDA is often neglected as a condition per se in CKD, which can lead to worsening outcomes for patients.(4) Understanding the key principles of iron metabolism is fundamental to appreciating the advantages and limitations of the diagnostic tests and treatment options available in the management of ID/IDA in CKD.

The ‘Module 1: Physiology of iron metabolism’, made available on and organized by Litmus MME,
is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to provide the following CME activity for medical specialists. It was developed with scientific input and guidance from Professor Angel de Francisco (Head of the Dialysis Unit and Nephrology Section at the Hospital Universitario Valdecilla, Santander, Spain). The module is available in a user-friendly interactive presentation format that is divided over four chapters to enable you to learn at your own pace and gain maximum benefit from the information presented.

Chapters 1 and 2 provide you with a comprehensive overview of iron physiology, including the different types of iron available, the various dietary sources of iron, how iron is distributed throughout the body and the many functions involving iron within the body, beyond red blood cell production. Chapters 3 and 4 explore how iron homeostasis is maintained in the body and the principal proteins involved in iron transport and storage in the body, especially ferritin and transferrin.

Interactive question-and-answer sections at the end of each chapter will evaluate your learning and improve your understanding of the physiology of iron metabolism.

The ‘Module 1: Physiology of iron metabolism’ made available on and organized by Litmus MME
is awarded 1 European CME credit (ECMEC’s).
Each medical specialist should claim only those credits that he/she actually spent in the educational activity. The EACCME is an institution of the European Union of Medical Specialists (UEMS). Only those e-learning materials that are displayed on the UEMS-EACCME website have formally been accredited.


  1. Goodnough LT. Iron deficiency syndromes and iron-restricted erythropoiesis. Transfusion 2012;52:1584–1592.
  2. Macdougall IC, Horl WH, Jacobs C, et al. European best practice guidelines 6-8: assessing and optimizing iron stores. Nephrol Dial Transplant 2000;15 Suppl 4:20–32.
  3. Fishbane S, Pollack S, Feldman HI, et al. Iron indices in chronic kidney disease in the National Health and Nutritional Examination Survey 1988-2004. Clin J Am Soc Nephrol 2009;4:57–61.
  4. Krikorian S, Shafai G, Shamim K. Managing iron deficiency anemia of CKD with IV iron. US Pharmacist 2013;38:22–26.


Date of preparation: 19 September 2014
Target Audience: Nephrologists and pharmacists of all seniority levels who want to understand the basic physiology of iron metabolism.
Duration: 1 hour
Learning requirements: To complete the learning module successfully and obtain 1 CME credit, you need to achieve at least 60% of correct answers.

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