Effect of intravenous iron on outcomes of acute kidney injury

Transfusion
Barbara A ClarkRichard Marcus

Abstract

Little is known about benefit versus risk in treating iron deficiency anemia with intravenous (IV) iron in patients with acute kidney injury (AKI). Concerns about adverse outcomes may dissuade use and could contribute to greater use of red blood cell (RBC) transfusion. We performed a retrospective case-control study of patients with AKI who received IV iron (cases) compared to those with AKI without IV iron (controls). We identified 67 cases and 67 controls matched for age, stage of chronic kidney disease, and severity of anemia (hemoglobin [Hb], 7.7 ± 0.1 mg/dL vs. 7.5 ± 0.1 mg/dL; p = 0.47). Cases tended to be sicker with longer length of stay (27 + 4 days vs. 15 + 1.3 days; p = 0.003) and more intensive care unit days (13 + 2 days vs. 5 + 1 days; p = 0.003), more often with diagnosis of sepsis and greater number of antibiotics used (2.7 ± 0.3 vs. 1.8 ± 0.2; p = 0.02). Sepsis and AKI preceded use of IV iron. Despite greater illness severity, there was no difference in dialysis (38.8% vs. 34.3%; p = 0.59), mortality (24% vs. 21%; p = 0.679), or severity and/or recovery of AKI. Discharge Hb was similar (9.0 ± 0.1 mg/dL vs. 9.1 ± 0.1 mg/dL; p = 0.47). IV iron was used later in the stay and hence the cases also had more RBC trans...Continue Reading

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Citations

Sep 26, 2017·Transfusion·Lyla A Youssef, Steven L Spitalnik

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