Safety of Intravenous Iron in Dialysis: A Systematic Review and Meta-Analysis

Clinical Journal of the American Society of Nephrology : CJASN
Ingrid HougenNavdeep Tangri

Abstract

The safety of intravenous iron dosing in dialysis is uncertain. Higher-dose intravenous iron may be associated with a higher risk of infections, cardiovascular events, hospitalizations, and mortality. This systematic review aimed to determine the safety of higher-dose versus lower-dose intravenous iron, oral iron, or no iron supplementation in adult patients treated with dialysis. We searched Medline, EMBASE, Cochrane library, and CINAHL from inception to January 6, 2017 for randomized, controlled trials and observational studies comparing higher-dose intravenous iron with lower-dose intravenous iron, oral iron, or no iron in patients treated with dialysis that had all-cause mortality, infection, cardiovascular events, or hospitalizations as outcomes. Of the 2231 eligible studies, seven randomized, controlled trials and 15 observational studies met inclusion criteria. The randomized, controlled trials showed no association between higher-dose intravenous iron (>400 mg/mo for most studies) and mortality (six studies; n=970; pooled relative risk, 0.93; 95% confidence interval, 0.47 to 1.84; follow-up ranging from 35 days to 26 months) or infection (four studies; n=743; relative risk, 1.02; 95% confidence interval, 0.74 to 1.41). ...Continue Reading

References

Jan 1, 1990·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·J R BoelaertH W Van Landuyt
Jul 1, 1995·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·S FishbaneJ Maesaka
Jan 10, 2001·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·D HaguenauerG Wells
Jun 23, 2001·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·L Jovanovic
Sep 6, 2003·BMJ : British Medical Journal·Julian P T HigginsDouglas G Altman
May 22, 2004·Journal of the American Society of Nephrology : JASN·Harold I FeldmanGerald Faich
Jun 24, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Ronald L PisoniFriedrich K Port
Jul 22, 2005·Journal of the American Society of Nephrology : JASN·Kamyar Kalantar-ZadehDavid G Warnock
Nov 17, 2006·The New England Journal of Medicine·Tilman B DrüekeUNKNOWN CREATE Investigators
Nov 17, 2006·The New England Journal of Medicine·Ajay K SinghUNKNOWN CHOIR Investigators
Apr 4, 2007·Hemodialysis International·Robert C KopelmanAdel R Rizkala
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Harmeet SinghUNKNOWN United States Iron Sucrose (Venofer) Clinical Trials Group
Jan 25, 2008·Journal of the American Society of Nephrology : JASN·Toros KapoianDaniel W Coyne
Jan 30, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Robert ProvenzanoBrian J G Pereira
Jul 23, 2009·Annals of Internal Medicine·David MoherUNKNOWN PRISMA Group
Nov 3, 2009·The New England Journal of Medicine·Marc A PfefferUNKNOWN TREAT Investigators
Sep 10, 2010·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Thomas SonnweberGünter Weiss
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Apr 16, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Francesco LocatelliUNKNOWN ERA-EDTA ERBP Advisory Board
Jun 19, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Richard A HirthJoseph A Messana
Jun 22, 2013·Journal of the American Society of Nephrology : JASN·M Alan BrookhartAbhijit V Kshirsagar
Jul 31, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Alan S KligerLynda Szczech
Sep 24, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Louise M MoistBraden J Manns
Oct 1, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·George R BailieBruce M Robinson
Jul 26, 2014·Journal of the American Society of Nephrology : JASN·Julia B LewisUNKNOWN Collaborative Study Group
Oct 17, 2014·Clinical Journal of the American Society of Nephrology : CJASN·Dana C MiskulinUNKNOWN Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Network Patient Outcomes in End Stage Renal Disease Stu
Nov 5, 2014·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Navdeep TangriUNKNOWN DEcIDE Network Patient Outcomes in End-Stage Renal Disease Study Investigators
Dec 9, 2014·The Cochrane Database of Systematic Reviews·Suetonia C PalmerGiovanni F M Strippoli
Sep 30, 2015·Clinical Journal of the American Society of Nephrology : CJASN·Julie H IshidaKirsten L Johansen
Feb 27, 2016·Journal of the American Society of Nephrology : JASN·Glenn M ChertowAllan J Collins
Oct 25, 2016·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Daniel ShepshelovichAnat Gafter-Gvili

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Citations

Jun 18, 2018·Seminars in Dialysis·Takeshi HasegawaTadao Akizawa
Jun 16, 2018·Current Opinion in Nephrology and Hypertension·Iain C Macdougall
Oct 27, 2018·The New England Journal of Medicine·Iain C MacdougallUNKNOWN PIVOTAL Investigators and Committees
Mar 1, 2019·Journal of Medical Economics·Bruce SpinowitzHolly B Krasa
Feb 22, 2018·Clinical Journal of the American Society of Nephrology : CJASN·Xiaojuan Li, Abhijit V Kshirsagar
Apr 2, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Francesco Locatelli, Lucia Del Vecchio
Oct 5, 2019·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Rachel L PerlmanJeffrey Perl
Nov 26, 2019·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Alon BnayaItzchak Slotki
Sep 6, 2019·International Urology and Nephrology·Sohail Abdul SalimTibor Fülöp
Jun 12, 2019·Clinical Journal of the American Society of Nephrology : CJASN·David Collister, Navdeep Tangri
Apr 3, 2020·Current Opinion in Nephrology and Hypertension·Sanjeev Nair, Mayuri Trivedi
Jul 3, 2020·Canadian Journal of Kidney Health and Disease·Paweena SusantitaphongKearkiat Praditpornsilpa
Apr 17, 2019·Clinical Journal of the American Society of Nephrology : CJASN·Xiaojuan LiM Alan Brookhart
Apr 8, 2020·Journal of the American Society of Nephrology : JASN·Iain C MacdougallUNKNOWN PIVOTAL Investigators and Committees
Mar 11, 2020·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Laura GobbiLorenzo A Calò
Sep 4, 2019·Advances in Chronic Kidney Disease·Abhijit V Kshirsagar, Xiaojuan Li
Feb 1, 2021·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Aleix CasesUNKNOWN en representación del Grupo de Anemia de la S.E.N.
Nov 19, 2020·Expert Opinion on Drug Safety·Xenophon KassianidesSunil Bhandari
Feb 11, 2021·Clinical Kidney Journal·Takeshi Nakanishi, Takahiro Kuragano
Apr 4, 2021·Journal of Clinical Medicine·Roberto MinutoloFrancesco Locatelli
Jun 1, 2021·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Aleix CasesUNKNOWN en representación del Grupode Anemia de la S.E.N.
Jun 18, 2021·Kidney Medicine·Philip Kam Tao LiXueqing Yu
Jul 1, 2021·Clinical Kidney Journal·Lucia Del VecchioUNKNOWN ERA-EDTA European Renal and Cardiovascular Medicine Working (EURECA-m) Group
Apr 11, 2019·Acta Haematologica·Thomas G DeLoughery

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