Abstract: FR-PO0403
Inflammation-Driven Differential Response to Intravenous vs. Oral Iron Supplementation in Patients on Hemodialysis: Post Hoc Analysis of the IHOPE Trial
Session Information
- Dialysis: Measuring and Managing Symptoms and Syndromes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Jin, Haijiao, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
- Lu, Renhua, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
- Cao, Juan, Taixing People's Hospital, Taixing, China
- Li, Hua, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
- Wang, Xiaoxia, Tongren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China
- Qi, Yinghui, Shanghai Punan Hospital, Shanghai, China
- Li, Qiu, The First People's Hospital of Shuangliu, Chengdu, China
- Cai, Xudong, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, China
- Song, Bin, Deyang People's Hospital, Deyang, Sichuan, China
- Li, Na, Jinan Zhangqiu District People's Hospital, Jinan, China
- Shen, Lianglan, Nantong First People's Hospital, Nantong, Jiangsu, China
- Wang, Li, Shandong Province Qianfoshan Hospital, Jinan, China
- Wang, Xiaoping, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Ni, Zhaohui, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
Background
The impact of inflammatory status on efficacy of different iron administration routes in maintenance hemodialysis(MHD) patients remains unclear. We evaluated how baseline inflammation influences responses to intravenous versus oral iron supplementation.
Methods
In this IHOPE trial post hoc analysis, 193 MHD patients were categorized by median baseline hsCRP and randomized to receive intravenous iron sucrose (100mg biweekly) or oral polysaccharide-iron complex (150mg twice daily) for 24 weeks. Primary outcome was hemoglobin at 24 weeks.
Results
Low (n=96) and high (n=97) hsCRP groups had comparable baseline hemoglobin (117.5±23.9 vs 114.5±8.0 g/L). At 24 weeks, the high hsCRP group showed lower hemoglobin (113.8±12.0 vs 118.0±13.5 g/L, P=0.038). In the intravenous iron group, patients with high baseline hsCRP had significantly lower hemoglobin at 24 weeks compared to low hsCRP patients (112.90 vs 121.32 g/L; P=0.005), whereas hemoglobin levels were similar between subgroups receiving oral iron (114.74 vs 114.45 g/L; P=0.913). High baseline hsCRP patients receiving intravenous iron maintained elevated hsCRP (3.84 vs 0.79 mg/L; P=0.004) and higher superoxide dismutase levels (21.80 vs 13.57 U/mL; P=0.021), suggesting enhanced oxidative stress. These differences were absent in the oral iron group.
Conclusion
Inflammatory status significantly influences iron supplementation efficacy in MHD patients. Personalized iron supplementation strategies based on inflammatory status may optimize anemia management.
Figure 1. Comparison of Oral Polysaccharide-Iron Complex and Intravenous Iron Sucrose on Hemoglobin, hsCRP, and SOD Levels in Patients Stratified by Baseline hsCRP.