Observational studyPloS one2014
Iron supplementation and mortality in incident dialysis patients: an observational study.
Observational study in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Comparative iron management in hemodialysis and peritoneal dialysis patients: a systematic review.Frontiers in nephrology · 2024Pooled it
- Risk of Infection Associated With Administration of Intravenous Iron: A Systematic Review and Meta-analysis.JAMA network open · 2021Pooled it
- Management of Iron-Deficiency Anemia in Inflammatory Bowel Disease: A Systematic Review.Medicine · 2015Pooled it
- Trial
- Exploring the relationship between intravenous iron therapy and troponin T levels in hemodialysis patients: a cross-sectional study.BMC nephrology · 2025Article
- High Serum Ferritin Levels Are Associated with Sarcopenia in Patients Undergoing Chronic Hemodialysis.Nutrients · 2025Article
- High Ferritin and Low Total Iron-Binding Capacity in Plasma Predict All-Cause Mortality During the First 3 Years of Hemodialysis in Patients with End-Stage Chronic Kidney Disease.International journal of general medicine · 2024Article
- Elevated Ferritin Levels Associated with High Body Fat Mass Affect Mortality in Peritoneal Dialysis Patients.Nutrients · 2023Article
- Iron deficiency in sepsis patients managed with divided doses of iron dextran: a prospective cohort study.Scientific reports · 2023Article
- Construction data mining methods in the prediction of death in hemodialysis patients using support vector machine, neural network, logistic regression and decision tree.Journal of preventive medicine and hygiene · 2021Article
- Clinical outcomes of incident peritoneal dialysis patients coming from kidney transplantation program: A case-control study.PloS one · 2020Article
- The Impact of CKD Anaemia on Patients: Incidence, Risk Factors, and Clinical Outcomes-A Systematic Literature Review.International journal of nephrology · 2020Article
- Review
- Role of redox iron towards an increase in mortality among patients: a systemic review and meta-analysis.Blood research · 2019Review
- Treatment of anaemia in end-stage renal disease: A double-edged iron sword?EBioMedicine · 2019Article
- Intravenous Irons: From Basic Science to Clinical Practice.Pharmaceuticals (Basel, Switzerland) · 2018Review
- Impact of Inflammation on Ferritin, Hepcidin and the Management of Iron Deficiency Anemia in Chronic Kidney Disease.Nutrients · 2018Review
- Review
- Safety of intravenous iron in hemodialysis patients.Hemodialysis international. International Symposium on Home Hemodialysis · 2017Review
- Serum Ferritin Variations and Mortality in Incident Hemodialysis Patients.American journal of nephrology · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies on the association between iron supplementation and mortality in dialysis patients are rare and conflicting.
methodsIn our observational single-center cohort study (INVOR study) we prospectively studied 235 incident dialysis patients. Time-dependent Cox proportional hazards models using all measured laboratory values for up to 7.6 years were applied to study the association between iron supplementation and all-cause mortality, cardiovascular and sepsis-related mortality. Furthermore, the time-dependent association of ferritin levels with mortality in patients with normal C-reactive protein (CRP) levels (<0.5 mg/dL) and elevated CRP levels (≧0.5 mg/dL) was evaluated by using non-linear P-splines to allow flexible modeling of the association.
resultsOne hundred and ninety-one (81.3%) patients received intravenous iron, 13 (5.5%) patients oral iron, whereas 31 (13.2%) patients were never supplemented with iron throughout the observation period. Eighty-two (35%) patients died during a median follow-up of 34 months, 38 patients due to cardiovascular events and 21 patients from sepsis. Baseline CRP levels were not different between patients with and without iron supplementation. However, baseline serum ferritin levels were lower in patients receiving iron during follow up (median 93 vs 251 ng/mL, p<0.001). Iron supplementation was associated with a significantly reduced all-cause mortality [HR (95%CI): 0.22 (0.08-0.58); p = 0.002] and a reduced cardiovascular and sepsis-related mortality [HR (95%CI): 0.31 (0.09-1.04); p = 0.06]. Increasing ferritin concentrations in patients with normal CRP were associated with a decreasing mortality, whereas in patients with elevated CRP values ferritin levels>800 ng/mL were linked with increased mortality.
conclusionsIron supplementation is associated with reduced all-cause mortality in incident dialysis patients. While serum ferritin levels up to 800 ng/mL appear to be safe, higher ferritin levels are associated with increased mortality in the setting of concomitant inflammation.
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