Oral iron therapies in development for iron deficiency in chronic kidney disease

Author(s): David William Mudge & David Wayne Johnson

Iron supplementation remains a key component of anemia management in chronic kidney disease, which is associated with functional as well as absolute iron deficiency. There remains concern about the risks of intravenous iron, but oral iron supplements are poorly absorbed due to hepcidin-induced absorption block and are associated with gastrointestinal intolerance. Newer iron preparations with greater bioavailability and better tolerability than ferrous sulfate, or other agents which bypass the gastrointestinal block of iron absorption, offer the potential for normalizing iron stores without the need for intravenous iron. We review the current status of available iron supplements and summarize the recent clinical trial evidence for their use, with a particular focus on new oral supplements and those currently in development.