Important considerations in iron management and nutritional status in select hemodialysis populations.

Patients on hemodialysis frequently encounter multiple complications during the course of therapy. Anemia occurs from impaired erythropoiesis stemming from chronic kidney disease and loss of blood and iron during the hemodialysis process. Dietary restrictions are often necessary in patients on hemodialysis to maintain adequate nutritional status and prevent the accumulation of nutrients that are not effectively removed with hemodialysis. These factors can significantly affect a patient's iron status and result in iron-restricted erythropoiesis and eventually absolute iron deficiency. This article describes the role that nephrology nurses have in effectively managing nutrition, iron status, and anemia in patients on hemodialysis and highlights important clinical characteristics that should be considered in select racial or ethnic populations. The results of an initiative within one dialysis network to track dietary intake and administer appropriate anemia treatment, including intravenous iron, through an educational program are examined.