Abstract: PUB038
IV Iron in Iron-Deficient, Nonanaemic Patients with Nondialysis-Dependent (ND)-CKD: A Systematic Review
Session Information
Category: Anemia and Iron Metabolism
- 200 Anemia and Iron Metabolism
Authors
- Spencer, Sebastian, University of Hull, Hull, England, United Kingdom
- Skidmore, Megan, Hull York Medical School, Hull, England, United Kingdom
- Bhandari, Sunil, Hull University Teaching Hospitals NHS Trust, Hull, England, United Kingdom
Background
Iron deficiency is common in ND-CKD and may cause symptoms such as fatigue and restless legs, even in the absence of anaemia. While IV iron is widely used in haemodialysis, its safety and efficacy in iron-deficient but non-anaemic ND-CKD remain unclear. Guidelines lack specific recommendations for this group, except in patients with heart failure. Trials in CKD and heart failure suggest potential benefit, but applicability to this population is uncertain. This systematic review aims to assess the safety, efficacy, and patient outcomes of IV iron in ND-CKD with confirmed ID and Hb 110–150 g/L.
Methods
We will include RCTs and prospective or retrospective cohort studies of adults (≥18 years) with ND-CKD (eGFR <60) and iron deficiency (ferritin <100 μg/L; or ferritin >100 μg/L with TSAT <20%; or CHr <31 pg; or HRC >6%). Studies assessing IV iron with or without comparators will be included. Case reports and non-English studies will be excluded. Primary outcome: efficacy of IV iron. Secondary outcomes: cardiovascular events, infections, symptom burden, function, cognition, quality of life, and acceptability.
Results
Ten studies met inclusion criteria, with a combined population of 4026 participants. Data synthesis is ongoing and will be presented at the conference.
Conclusion
This review addresses a key evidence gap in managing iron deficiency in ND-CKD without anaemia. Findings may inform future research, guideline development, and clinical practice.
Included studies and participants
| Study Title | Number of Participants |
| McMahon 2010 | 100 |
| Ponikowski 2015 | 459 |
| Marques 2023 | 120 |
| van Veldhuisen 2017 | 172 |
| Kalra 2022 | 1137 |
| von Haehling 2024 | 39 |
| Al Sahow 2022 | 738 |
| Greenwood 2023 | 75 |
| Bhandari 2021 | 54 |
| Macdougall 2023 | 1132 |