High-Dose Intravenous Iron Shows Superior Hematological Benefits for Hemodialysis Patients with Renal Anemia

A recent systematic review and meta-analysis evaluated the effects of high-dose intravenous iron on hematological outcomes and cardiovascular events in hemodialysis patients with renal anemia.

The study, which included data from six randomized clinical trials involving 2,422 patients, compared high-dose intravenous iron with low-dose iron treatment to determine its impact on following key parameters:

• hemoglobin

• transferrin saturation

• ferritin levels

• erythropoietin (EPO) dose

• cardiovascular events

The findings indicated that high-dose intravenous iron treatment was associated with significant improvements in ferritin, transferrin saturation, and hemoglobin levels compared to low-dose iron.

Additionally, patients receiving high-dose iron required a lower dose of erythropoietin to maintain optimal hemoglobin levels. However, the analysis also explored cardiovascular events, though no significant increase in such events was noted with high-dose iron therapy.

These results suggest that high-dose intravenous iron therapy may offer superior hematological benefits in the management of renal anemia in hemodialysis patients, potentially reducing the need for erythropoietin and improving iron storage markers. The study supports the use of higher iron doses as an effective strategy in treating renal anemia, although the long-term cardiovascular safety remains an area for further investigation.