IV Iron in Hospitalized Hemodialysis Patients Not Linked With Worsening Infections

Dr. Julie H. Ishida MD San Francisco Veterans Affairs Medical Center Nephrology Section San Francisco, CAMedicalResearch.com Interview with:
Dr. Julie H. Ishida MD
San Francisco Veterans Affairs Medical Center
Nephrology Section
San Francisco, CA

Medical Research: What is the background for this study? What are the main findings?

Dr. Ishida: Intravenous iron is important in the treatment of anemia of end-stage renal disease, but it is biologically plausible that iron may increase infection risk. While results from epidemiologic studies evaluating the association between intravenous iron and infection in hemodialysis patients have been conflicting, guidelines for the treatment of anemia of chronic kidney disease have recommended caution in prescribing, avoidance and withholding of intravenous iron in the setting of active infection. However, no data specifically support the recommendation to withhold intravenous iron during active infection.

Our study observed that among hemodialysis patients hospitalized for bacterial infection who had been receiving intravenous iron as an outpatient, continued receipt of intravenous iron was not associated with higher all-cause mortality, readmission for infection, or longer hospital stay.

Medical Research: What should clinicians and patients take away from your report?

Dr. Ishida: While the observational nature of our study precludes definitive conclusions, our analysis does not support withholding intravenous iron upon admission for bacterial infection in hemodialysis patients.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Ishida: Further examination of the effect of intravenous iron on adverse outcomes using clinical trials is necessary before recommending changes in intravenous iron prescribing practices for hemodialysis patients.

Citation:

Julie H. Ishida, Ben J. Marafino, Charles E. McCulloch, Lorien S. Dalrymple, R. Adams Dudley, Barbara A. Grimes, and Kirsten L. Johansen

Receipt of Intravenous Iron and Clinical Outcomes among Hemodialysis Patients Hospitalized for InfectionCJASN CJN.01090115; published ahead of print September 28, 2015,doi:10.2215/CJN.01090115

Dr. Julie H. Ishida MD (2015). IV Iron in Hospitalized Hemodialysis Patients Not Linked With Worsening Infections

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