Abstract: TH-PO0513
Efficacy and Safety of High-Dose Intravenous Iron in the Treatment of Iron Deficiency Anemia in Patients on Hemodialysis: A Systematic Review and Meta-Analysis
Session Information
- Dialysis: Novel Therapeutics and Medication Management
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Campoverde, Clara, Universidad de Cuenca, Cuenca, Azuay, Ecuador
- Szyferman, Alanis Yael, Universidad Hospital Italiano de Buenos Aires, Autónoma de Buenos Aires, Buenos Aires, Argentina
- Napoli, Federico, IRCCS Multimedica Milan, San Giuseppe Hospital, Milan, Italy
- Nnajiofor, Ifunanya Peculiar, Basingstoke and North Hampshire Hospital, Basingstoke, England, United Kingdom
- Neves, Henrique Alexsander Ferreira, Universidade Federal do Parana, Curitiba, PR, Brazil
- Dibo, Paula, The University of Alabama at Birmingham, Birmingham, Alabama, United States
Background
The optimal dosing strategy for intravenous iron (IV) in hemodialysis (HD) patients with iron deficiency anemia remains uncertain. While high-dose IV iron is commonly used, concerns exist regarding its potential risks. This systematic review and meta-analysis aims to assess the efficacy and safety of high-dose IV iron in this population.
Methods
PubMed, Embase and Cochrane databases were searched for randomized controlled trials (RCTs) comparing high-dose with low-dose IV iron or no iron in HD patients with iron deficiency anemia. Risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) were pooled across studies. Heterogeneity was assessed using I2 statistics.
Results
This analysis included five RCTs involving 2,614 patients, of whom 1,326 (50.7%) received high-dose IV iron. Mean follow-up ranged from 1.5 to 25.2 months. There was no significant difference between groups in the change from baseline in hemoglobin (MD 0.15 g/dL; 95% CI –0.26 to 0.57; p=0.47) or ferritin levels (SMD 0.98; 95% CI 0.71 to 1.26; p<0.001). In contrast, transferrin saturation was significantly increased in the high-dose IV iron group compared with control (MD 5.02 %; 95% CI 3.17 to 6.87; p<0.001). No statistically significant differences were observed between groups for cardiac adverse events (p=0.064), cardiovascular mortality (p=0.440), vascular disorders (p=0.487), or infections (p=0.948).
Conclusion
High-dose IV iron demonstrated a safety profile comparable to that of low-dose or no IV iron and was associated with significant increases in transferrin saturation, despite no improvements in hemoglobin or ferritin levels.