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Key Points Iron deficiency is prevalent in patients with chronic kidney disease (CKD) and should be treated Inconsistent and inadequate absorption of oral iron frequently leads to the need for administration of intravenous iron Hepcidin (levels of which are frequently increased in patients with CKD) impairs iron absorption and the normal recycling of iron through the reticuloendothelial system Low levels of serum ferritin and transferrin saturation indicate iron deficiency, but values in or above the normal range lack diagnostic value Frequent, small repeat doses of intravenous iron are more effective than infrequent, large doses for maintaining levels of hemoglobin and reducing the requirement for erythropoiesis-stimulating agents (ESAs) Relative thrombocytosis (owing to iron deficiency) might contribute to the increased cardiovascular risk seen with high ESA doses This is a preview of subscription content, access via your institution Access options Subscribe to this journal Receive 12 print issues and online access 176,64 per year only 14,72 per issue Buy this article Purchase on SpringerLink Instant access to the full article PDF