ArticleClinical journal of the American Society of Nephrology : CJASN2014
Intravenous iron exposure and mortality in patients on hemodialysis.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Influence of intravenous iron therapy on mortality and cardiovascular events of patients on hemodialysis: A meta-analysis.Biomolecules & biomedicine · 2025Pooled it
- Infectious complications and mortality associated with the use of IV iron therapy: a systematic review and meta-analysis.International urology and nephrology · 2019Pooled it
- Efficacy and safety of single high-dose intravenous ferric carboxymaltose in patients undergoing hemodialysis: a multicenter, single-arm, open-label, clinical trial.BMC nephrology · 2026Trial
- Trial
- Parenteral iron-Does it increase infection risk?Vox sanguinis · 2026Review
- Association of Estimated Total Body Iron with All-Cause Mortality in Japanese Hemodialysis Patients: The Miyazaki Dialysis Cohort Study.Nutrients · 2023Article
- Anemia biomarkers and mortality in hemodialysis patients with or without diabetes: A 10-year follow-up study.PloS one · 2023Article
- The prevalence of cardiac and hepatic iron overload in patients with kidney failure: A protocol for systematic review and meta-analysis.Health science reports · 2022Article
- Intravenous iron therapy and the cardiovascular system: risks and benefits.Clinical kidney journal · 2021Review
- Potential hazards of recent trends in liberal iron use for renal anemia.Clinical kidney journal · 2021Review
- Low hemoglobin at hemodialysis initiation: an international study of anemia management and mortality in the early dialysis period.Clinical kidney journal · 2020Article
- Replicating Randomized Trial Results with Observational Data Using the Parametric g-Formula: An Application to Intravenous Iron Treatment in Hemodialysis Patients.Clinical epidemiology · 2020Article
- Clinical outcomes of incident peritoneal dialysis patients coming from kidney transplantation program: A case-control study.PloS one · 2020Article
- Risk of iron overload with chronic indiscriminate use of intravenous iron products in ESRD and IBD populations.Heliyon · 2019Review
- Trends in the treatment of chronic kidney disease-associated anaemia in a cohort of haemodialysis patients: the Irish experience.Irish journal of medical science · 2019Article
- Achievement of renal anemia KDIGO targets by two different clinical strategies - a European hemodialysis multicenter analysis.BMC nephrology · 2019Article
- Association between serum ferritin and mortality: findings from the USA, Japan and European Dialysis Outcomes and Practice Patterns Study.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2018Article
- Impact of Inflammation on Ferritin, Hepcidin and the Management of Iron Deficiency Anemia in Chronic Kidney Disease.Nutrients · 2018Review
- Intravenous Irons: From Basic Science to Clinical Practice.Pharmaceuticals (Basel, Switzerland) · 2018Review
- Medical safety in the care of the person with end-stage kidney disease.Seminars in dialysis · 2018Review
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Authors and funding
17 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND AND
objectivesClinical trials assessing effects of larger cumulative iron exposure with outcomes are lacking, and observational studies have been limited by assessment of short-term exposure only and/or failure to assess cause-specific mortality. The associations between short- and long-term iron exposure on all-cause and cause-specific mortality were examined. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The study included 14,078 United States patients on dialysis initiating dialysis between 2003 and 2008. Intravenous iron dose accumulations over 1-, 3-, and 6-month rolling windows were related to all-cause, cardiovascular, and infection-related mortality in Cox proportional hazards models that used marginal structural modeling to control for time-dependent confounding.
resultsPatients in the 1-month model cohort (n=14,078) were followed a median of 19 months, during which there were 27.6% all-cause deaths, 13.5% cardiovascular deaths, and 3% infection-related deaths. A reduced risk of all-cause mortality with receipt of >150-350 (hazard ratio, 0.78; 95% confidence interval, 0.64 to 0.95) or >350 mg (hazard ratio, 0.79; 95% confidence interval, 0.62 to 0.99) intravenous iron compared with >0-150 mg over 1 month was observed. There was no relation of 1-month intravenous iron dose with cardiovascular or infection-related mortality and no relation of 3- or 6-month cumulative intravenous iron dose with all-cause or cardiovascular mortality. There was a nonstatistically significant increase in infection-related mortality with receipt of >1050 mg intravenous iron in 3 months (hazard ratio, 1.69; 95% confidence interval, 0.87 to 3.28) and >2100 mg in 6 months (hazard ratio, 1.59; 95% confidence interval, 0.73 to 3.46).
conclusionsAmong patients on incident dialysis, receipt of ≤ 1050 mg intravenous iron in 3 months or 2100 mg in 6 months was not associated with all-cause, cardiovascular, or infection-related mortality. However, nonstatistically significant findings suggested the possibility of infection-related mortality with receipt of >1050 mg in 3 months or >2100 mg in 6 months. Randomized clinical trials are needed to assess the safety of exposure to greater cumulative intravenous iron doses.
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