High-dose parenteral iron does not seem to be associated with higher risk of infection , all-cause mortality , increased hospitalization or increased cardiovascular events on analysis of RCTs .
Observational studies show increased risk for all-cause mortality , infections and hospitalizations that were not statistically significant and were associated with significant heterogeneity
Parental iron is used to optimize hemoglobin and enhance erythropoiesis in end-stage renal disease along with erythropoietin-stimulating agents .
Safety of iron has been debated extensively and there is no definite evidence whether parenteral iron increases the risk of infections and mortality .
We performed this meta- analysis to evaluate the incidence of infectious complications , hospitalizations and mortality with use of parenteral iron .
Functional iron deficiency in hemodialysis patients with high ferritin
Although functional iron deficiency ( FID ) may be present in hemodialysis ( HD ) patients with high serum ferritin levels ( > 800 ng/mL ) , current protocol s often preclude the use of intravenous ( IV ) iron in these patients . However , it has not been demonstrated that iron supplementation during erythropoietin therapy is ineffective or unsafe in increasing hemoglobin ( Hb ) levels in patients with high serum ferritin . This report describes the hematologic efficacy and safety of ferric gluconate ( FG ) therapy in patients with serum ferritin > 800 ng/mL. A retrospective analysis was performed on HD patients at a single California dialysis center from January 1 to December 31 , 2003 . Patients classified as having high ferritin levels ( serum ferritin > 800 ng/mL on at least 66 % of routine monthly measurements and transferrin saturation [ TSAT ] < 25 % on at least 1 occasion ) were stratified as follows : patients in Group I were suspected of having FID and received FG ≥250 mg IV over a 3‐month period when Hb was < 11 g/dL , and patients in Group II were thought not to have FID and received < 250 mg FG over a 3‐month period . Both groups received st and ard recombinant human erythropoietin therapy as per the unit 's protocol . Of 496 patients , 95 exhibited high ferritin and of these , 39 patients had sufficient data for analysis . Group I patients ( n=14 ) showed a significant increase in Hb levels compared with Group II ( n=25 ) . There was no increase in ferritin levels in response to iron administration . No significant differences in hospitalizations or infections were observed between groups . Hemodialysis patients with high ferritin levels may have FID , and IV iron therapy safely improves FID in some patients . A larger r and omized trial examining the optimal management of iron administration in HD patients with high ferritin levels is warranted
High-dose parenteral iron does not seem to be associated with higher risk of infection , all-cause mortality , increased hospitalization or increased cardiovascular events on analysis of RCTs .
Observational studies show increased risk for all-cause mortality , infections and hospitalizations that were not statistically significant and were associated with significant heterogeneity
Parental iron is used to optimize hemoglobin and enhance erythropoiesis in end-stage renal disease along with erythropoietin-stimulating agents .
Safety of iron has been debated extensively and there is no definite evidence whether parenteral iron increases the risk of infections and mortality .
We performed this meta- analysis to evaluate the incidence of infectious complications , hospitalizations and mortality with use of parenteral iron .