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 .
Association between hemoglobin variability, serum ferritin levels, and adverse events/mortality in maintenance hemodialysis patients.
In recent times , therapy for renal anemia has changed dramatically in that iron administration has increased and doses of erythropoiesis-stimulating agents ( ESAs ) have decreased . Here we used a prospect i ve , observational , multicenter design and measured the serum ferritin and hemoglobin levels every 3 months for 2 years in 1086 patients on maintenance hemodialysis therapy . The associations of adverse events with fluctuations in ferritin and hemoglobin levels and ESA and iron doses were measured using a Cox proportional hazards model for time-dependent variables . The risks of cerebrovascular and cardiovascular disease ( CCVD ) , infection , and hospitalization were higher among patients who failed to maintain a target-range hemoglobin level and who exhibited high-amplitude fluctuations in hemoglobin compared with patients who maintained a target-range hemoglobin level . Patients with a higher compared with a lower ferritin level had an elevated risk of CCVD and infectious disease . Moreover , the risk of death was significantly higher among patients with high-amplitude ferritin fluctuations compared with those with a low ferritin level . The risks of CCVD , infection , and hospitalization were significantly higher among patients who were treated with high weekly doses of intravenous iron compared with no intravenous iron . Thus , there is a high risk of death and /or adverse events in patients with hemoglobin levels outside the target range , in those with high-amplitude hemoglobin fluctuations , in those with consistently high serum ferritin levels , and in those with high-amplitude ferritin fluctuations
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 .