Intravenous iron supplementation does not increase infectious disease risk in hemodialysis patients: a nationwide cohort-based case-crossover study.
Administration, Intravenous
Adult
Aged
Bacterial Infections
/ etiology
Cohort Studies
Cross-Over Studies
Databases, Factual
/ statistics & numerical data
Diabetes Mellitus
/ epidemiology
Epidemiologic Methods
Female
Ferric Compounds
/ administration & dosage
Ferric Oxide, Saccharated
/ administration & dosage
Heart Failure
/ epidemiology
Hematinics
/ administration & dosage
Humans
Iron
/ administration & dosage
Iron-Dextran Complex
/ administration & dosage
Kidney Failure, Chronic
/ epidemiology
Lung Diseases
/ epidemiology
Male
Middle Aged
Multimorbidity
National Health Programs
/ statistics & numerical data
Renal Dialysis
/ adverse effects
Taiwan
/ epidemiology
Time Factors
Young Adult
ESRD
Hemodialysis
Infection
Intravenous
Iron
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
22 08 2019
22 08 2019
Historique:
received:
13
02
2019
accepted:
26
07
2019
entrez:
24
8
2019
pubmed:
24
8
2019
medline:
5
11
2020
Statut:
epublish
Résumé
Studies have reported conflicting findings on the infection risk posed by intravenous iron supplementation among hemodialysis (HD) patients. We used a novel study design to assess associations between intravenous iron and infectious diseases. Patients initiating HD between 1998 and 2008 were extracted from Taiwan's National Health Insurance Research Database. Their first infectious disease in the period between 1.5 years after dialysis initiation and 2010 was identified and defined as the index date. Through the case-crossover design, the odds of exposure to intravenous iron within the 1-month period immediately preceding the index date (i.e., the case period) were compared with iron exposure in three different matched control periods for the same enrollee, thus possibly reducing some unmeasured confounders. A total of 1410 patients who met our enrollment criteria were extracted from incident HD patients. The odds of intravenous iron exposure during the case period versus total control periods exhibited no significant difference (odds ratio: 1.000, 95% confidence interval: 0.75-1.33). In subgroup analyses, this association remained nonsignificant across patients with diabetes mellitus, heart failure, chronic lung disease, venous catheter for HD, and higher iron load. We found that intravenous iron supplementation did not increase short-term infection risk among HD patients.
Sections du résumé
BACKGROUND
Studies have reported conflicting findings on the infection risk posed by intravenous iron supplementation among hemodialysis (HD) patients. We used a novel study design to assess associations between intravenous iron and infectious diseases.
METHODS
Patients initiating HD between 1998 and 2008 were extracted from Taiwan's National Health Insurance Research Database. Their first infectious disease in the period between 1.5 years after dialysis initiation and 2010 was identified and defined as the index date. Through the case-crossover design, the odds of exposure to intravenous iron within the 1-month period immediately preceding the index date (i.e., the case period) were compared with iron exposure in three different matched control periods for the same enrollee, thus possibly reducing some unmeasured confounders.
RESULTS
A total of 1410 patients who met our enrollment criteria were extracted from incident HD patients. The odds of intravenous iron exposure during the case period versus total control periods exhibited no significant difference (odds ratio: 1.000, 95% confidence interval: 0.75-1.33). In subgroup analyses, this association remained nonsignificant across patients with diabetes mellitus, heart failure, chronic lung disease, venous catheter for HD, and higher iron load.
CONCLUSIONS
We found that intravenous iron supplementation did not increase short-term infection risk among HD patients.
Identifiants
pubmed: 31438879
doi: 10.1186/s12882-019-1495-7
pii: 10.1186/s12882-019-1495-7
pmc: PMC6704706
doi:
Substances chimiques
Ferric Compounds
0
Hematinics
0
Iron-Dextran Complex
9004-66-4
Iron
E1UOL152H7
Ferric Oxide, Saccharated
FZ7NYF5N8L
ferric gluconate
W108RK810P
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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