Evidence map›Paper›PMID 40303218›Full record

ArticleKidney international reports2025

Systematic Review of the Effects of Iron on Cardiovascular, Kidney, and Safety Outcomes in Patients With CKD.

Bernard Chan, Amanda Varghese, Sunil V Badve, Roberto Pecoits-Filho, Murilo Guedes, Clare Arnott, Rebecca Kozor, Emma O'Lone, Min Jun, Sradha Kotwal and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Kidney international reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. KDIGO 2026 Clinical Practice Guideline for Anemia in Chronic Kidney Disease (CKD): a commentary from the European Renal Best Practice (ERBP).Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Bernard ChanDepartment of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Amanda VargheseDepartment of Renal Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Sunil V BadveRenal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Roberto Pecoits-FilhoArbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
Murilo GuedesArbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
Clare ArnottRenal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Rebecca KozorDepartment of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Emma O'LoneFaculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Min JunRenal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Sradha KotwalRenal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Geoffrey A BlockUS Renal Care, Denver, Colorado, USA.
Glenn M ChertowDepartment of Medicine, Stanford University School of Medicine, Stanford, California, USA.
Scott D SolomonCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Muthiah VaduganathanCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Vlado PerkovicDepartment of Renal Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Brendon L NeuenDepartment of Renal Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Heart failure and chronic kidney disease (CKD) are closely associated, and iron deficiency is highly prevalent in both conditions. However, major cardiovascular and nephrology guidelines offer contrasting recommendations for iron use. We evaluated the effects of iron versus usual care or placebo on the clinical outcomes in patients with CKD. Methods: We conducted a systematic review and meta-analysis of randomized trials on i.v. or oral iron in patients with CKD (PROSPERO CRD42023453468). We searched Medline, Embase, and the Cochrane Register from database inception until February 1, 2024 to identify eligible trials. We determined the overall results and stratified them by dialysis- and nondialysis-requiring CKD using random effects models, with certainty of evidence assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. The primary composite endpoint was hospitalization for heart failure or cardiovascular death. Results: We identified 45 trials that met the inclusion criteria. Compared with usual care or placebo, iron reduced the risk of the primary composite endpoint (1659 events; risk ratio [RR]: 0.84, 95% confidence interval [CI]: 0.75-0.94; moderate certainty), an effect consistent across dialysis and nondialysis requiring CKD ( Conclusion: Iron therapy may reduce the risk of heart failure and cardiovascular death in patients with CKD. Randomized trials evaluating the effects of iron on clinical outcomes are needed, especially in nondialysis patients with CKD with or without anemia.

Indexed as

cardiovascular outcomeschronic kidney diseaseheart failureiron therapies

Identifiers

PMID40303218
PMCPMC12034885

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.