Date of publication: October 9, 2015

Medical Education

Module 2: The Pathophysiology of Iron Deficiency

Iron deficiency/iron deficiency-anaemia (ID/IDA) is a common co-morbidity of chronic kidney disease (CKD)[1,2] and, if left untreated, can worsen the outcome of patients who already have compromised renal function.[3] We also now know that ID is not a single condition, but comprise multiple ID syndromes, with or without anaemia, which can even co-exist in a single patient.[4] Understanding the differences between ID syndromes will enable better clinical diagnosis that will facilitate the most appropriate treatment.

This e-learning module was developed with scientific input and guidance from Professor Carlo Gaillard (Chair of Nephrology at the University Medical Centre, Groningen, The Netherlands). The module is available in a user-friendly interactive presentation format that is divided over three chapters to enable you to learn at your own pace and gain maximum benefit from the information presented.

Chapter 1 reviews the prevalence of ID in patients with CKD and highlights the non-haematological consequence of ID. In addition, you will learn about the symptoms of ID and the two most relevant patho-mechanisms associated with the disorder. Chapter 2 introduces the concept of absolute and functional ID, and explores their different etiologies. Chapter 3 provides a summary of the most commonly used diagnostic markers for ID/IDA, including advantages and limitations, and recommended definitions and thresholds.

Interactive question-and-answer sections at the end of each chapter will evaluate your learning and improve your understanding of the pathophysiology of ID.


  1. 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.
  2. 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.
  3. Krikorian S, Shafai G, Shamim K. Managing iron deficiency anemia of CKD With IV iron. US Pharmacist 2013;38:22–26.
  4. Goodnough LT. Iron deficiency syndromes and iron-restricted erythropoiesis (CME). Transfusion 2012;52:1584–1592.


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