Intravenous (IV) vs oral iron therapy is not associated with
a higher risk for new-onset chronic kidney disease (CKD) among individuals with
normal kidney function and no proteinuria, investigators reported at the
American Society of Nephrology’s Kidney Week 2022 conference in Orlando,
Florida
Parenteral (IV) iron is effective in treating iron deficiency,
but there are concerns about its potential nephrotoxicity. However, little is
known about the long-term comparative renal safety of oral vs IV iron in
patients with normal kidney function. We aimed to investigate the association
of oral vs IV iron with the incidence of new onset chronic kidney disease
(CKD).
They identified 94,931 incident new users of iron
replacement therapy (N=91,945 on oral and 2,986 on IV iron) from 2004-2018 in a
large national cohort of US Veterans. We used clinical trial emulation methods
including propensity score (PS) matching to account for differences in key
baseline characteristics and limited the cohort to patients with eGFR >60
ml/mi/1.73m2 and urine albumin creatinine ratio (UACR) <30 mg/g. We examined
the association of oral vs IV iron with the incidence of eGFR 30 mg/g (both defined as two values at least 90 days
apart) using competing risk regression.
The result:
- In the PS matched cohort there were 1,029
patients on oral and 1,043 on IV iron with eGFR ≥60 ml/min/1.73m2 and UACR
<30 mg/g at baseline. - Their characteristics were well balanced, with
an overall mean (SD) age of 66±12 years, 92% male, 75% white, and baseline
eGFR, hemoglobin and ferritin levels of 90±18 ml/min/1.73m2, 9.7±1.8 g/dL and
34 µg/L, respectively. - There were 370 cases of incident GFR <60 and
251 cases of incident albuminuria over a median follow-up of 1.8 years. - IV (vs oral) iron therapy was associated with
similar risk of incident eGFR <60 and incident albuminuria
In this large national cohort of patients with baseline
normal kidney function and no proteinuria, IV iron therapy was not associated
with higher risk of incident CKD when compared to oral iron.
Reference:
Shrestha P, Paul S, Sumida K, et al. Association of
parenteral vs. oral iron therapy with incident CKD. Presented at: Kidney Week
2022; November 3-6, Orlando, Florida. Abstract TH-PO682.
Keywords:
Shrestha P, Paul S, Sumida K, Intravenous (IV) vs oral iron therapy is not associated with
a higher risk for new-onset chronic kidney disease (CKD) among individuals with
normal kidney function and no proteinuria, investigators reported at the
American Society of Nephrology’s Kidney Week 2022 conference in Orlando,
Florida
Parenteral (IV) iron is effective in treating iron deficiency,
but there are concerns about its potential nephrotoxicity. However, little is
known about the long-term comparative renal safety of oral vs IV iron in
patients with normal kidney function. We aimed to investigate the association
of oral vs IV iron with the incidence of new onset chronic kidney disease
(CKD).
They identified 94,931 incident new users of iron
replacement therapy (N=91,945 on oral and 2,986 on IV iron) from 2004-2018 in a
large national cohort of US Veterans. We used clinical trial emulation methods
including propensity score (PS) matching to account for differences in key
baseline characteristics and limited the cohort to patients with eGFR >60
ml/mi/1.73m2 and urine albumin creatinine ratio (UACR) <30 mg/g. We examined
the association of oral vs IV iron with the incidence of eGFR 30 mg/g (both defined as two values at least 90 days
apart) using competing risk regression.
The result:
- In the PS matched cohort there were 1,029
patients on oral and 1,043 on IV iron with eGFR ≥60 ml/min/1.73m2 and UACR
<30 mg/g at baseline. - Their characteristics were well balanced, with
an overall mean (SD) age of 66±12 years, 92% male, 75% white, and baseline
eGFR, hemoglobin and ferritin levels of 90±18 ml/min/1.73m2, 9.7±1.8 g/dL and
34 µg/L, respectively. - There were 370 cases of incident GFR <60 and
251 cases of incident albuminuria over a median follow-up of 1.8 years. - IV (vs oral) iron therapy was associated with
similar risk of incident eGFR <60 and incident albuminuria
In this large national cohort of patients with baseline
normal kidney function and no proteinuria, IV iron therapy was not associated
with higher risk of incident CKD when compared to oral iron.
Reference:
Shrestha P, Paul S, Sumida K, et al. Association of
parenteral vs. oral iron therapy with incident CKD. Presented at: Kidney Week
2022; November 3-6, Orlando, Florida. Abstract TH-PO682.
Keywords:
Shrestha P, Paul S, Sumida K, Association, parenteral, oral,
iron, therapy, incident CKD, Kidney Week 2022, parenteral, oral,
iron, therapy, incident CKD, Kidney Week 2022