ArticleCanadian journal of kidney health and disease2020
Effect of Maintenance Intravenous Iron Treatment on Erythropoietin Dose in Chronic Hemodialysis Patients: A Multicenter Randomized Controlled Trial.
Article in Canadian journal of kidney health and disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06906835 (Efficacy of Reticulocyte Hemoglobin Equivalent-guided Versus Transferrin Saturation-guided Iron Supplement Protocol in Hemodialysis Patients), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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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.
Efficacy of Reticulocyte Hemoglobin Equivalent-guided Versus Transferrin Saturation-guided Iron Supplement Protocol in Hemodialysis Patients: A Cluster Randomized Controlled Trial
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Influence of intravenous iron therapy on mortality and cardiovascular events of patients on hemodialysis: A meta-analysis.Biomolecules & biomedicine · 2025Pooled it
- Efficacy of Reticulocyte Haemoglobin Equivalent-Guided Versus Transferrin Saturation-Guided Iron Supplement Protocol in Haemodialysis Patients: A Multicenter Cluster Randomized Controlled Trial.Nephrology (Carlton, Vic.) · 2026Trial
- Maintenance intravenous iron in hemodialysis patients to minimize erythropoietin doses: a double-blinded, randomized controlled trial (the MAINTAIN IRON trial).Scientific reports · 2023Trial
- Systematic Review of the Effects of Iron on Cardiovascular, Kidney, and Safety Outcomes in Patients With CKD.Kidney international reports · 2025Article
- High-dose versus low-dose iron sucrose in individuals undergoing maintenance haemodialysis: a retrospective study.BMC nephrology · 2021Article
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12 authors.
Funding
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Abstract
backgroundThere is no consensus on intravenous (IV) iron supplement dose, schedule, and serum ferritin target in functional iron deficiency anemia to maintain optimum target levels of iron stores by several guidelines.
objectiveTo examine the effect of IV iron supplementation to different targets of serum ferritin on erythropoietin dose and inflammatory markers in chronic hemodialysis (HD) patients with functional iron deficiency anemia.
designA multicenter, randomized, open-label study.
settingIn a developing country, Thailand. PATIENTS: Chronic HD patients with functional iron deficiency anemia. MEASUREMENTS: Erythropoietin resistance index, high-sensitivity C-reactive protein, and fibroblast growth factor 23.
methodsTwo hundred adult chronic HD patients with transferrin saturation less than 30% and serum ferritin of 200 to 400 ng/mL were randomized 1:1 to maintain serum ferritin 200 to 400 ng/mL (low-serum ferritin group, N = 100) or 600 to 700 ng/mL (high-serum ferritin group, N = 100). During a 6-week titration period, participants randomized to the high-serum ferritin group initially received 600 mg IV iron (100 mg every week), while the participants in the low-serum ferritin group did not receive IV iron. During the 6-month follow-up period, the dose of IV iron was adjusted by protocol.
resultsThe mean dose of IV iron was 108.3 ± 28.2 mg/month in the low-serum ferritin group and 192.3 ± 36.2 mg/month in the high-serum ferritin group. The mean serum ferritin was 367.0 ± 224.9 ng/mL in the low ferritin group and 619.6 ± 265.2 ng/mL in the high ferritin group. The erythropoietin resistance index was significantly decreased in the high-serum ferritin group compared to the low-serum ferritin group after receiving IV iron in the 6-week titration period (mean difference: -113.43 ± 189.14 vs 41.08 ± 207.38 unit/week/g/dL; LIMITATIONS: Short follow-up period.
conclusionMaintaining a serum ferritin level of 600 to 700 ng/mL by IV iron administration of approximately 200 mg per month as a maintenance protocol can decrease erythropoietin dose requirements in chronic HD patients with functional iron deficiency anemia. TRIALS REGISTRATION: The study was registered with the Thai Clinical Trials Registry TCTR20180903003.
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