Association of oral iron replacement therapy with kidney failure and mortality in CKD patients.
chronic kidney disease
dialysis
end-stage kidney disease
iron replacement
mortality
Journal
Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
28
03
2023
medline:
2
11
2023
pubmed:
2
11
2023
entrez:
2
11
2023
Statut:
epublish
Résumé
Oral iron is the predominant route of iron replacement (IRT) but its benefits and safety are unclear in patients with chronic kidney disease (CKD). We examined the association of oral IRT vs no IRT with end-stage kidney disease (ESKD) and mortality in a national cohort of US Veterans. We identified 17 413 incident new users of oral IRT with estimated glomerular filtration rates <60 mL/min/1.73 m In the cohort of 49 943 patients, 1616 (3.2%) patients experienced ESKD and 28 711 (57%) patients died during a median follow-up of 1.9 years. Oral IRT was not associated with ESKD [subhazard ratio (HR) (95% confidence interval, CI) 1.00 (0.84-1.19), Oral IRT was associated with lower mortality only in patients with anemia. In patients without anemia, iron deficiency or CHF, the risk-benefit ratio of oral IRT should be further examined.
Sections du résumé
Background
UNASSIGNED
Oral iron is the predominant route of iron replacement (IRT) but its benefits and safety are unclear in patients with chronic kidney disease (CKD).
Methods
UNASSIGNED
We examined the association of oral IRT vs no IRT with end-stage kidney disease (ESKD) and mortality in a national cohort of US Veterans. We identified 17 413 incident new users of oral IRT with estimated glomerular filtration rates <60 mL/min/1.73 m
Results
UNASSIGNED
In the cohort of 49 943 patients, 1616 (3.2%) patients experienced ESKD and 28 711 (57%) patients died during a median follow-up of 1.9 years. Oral IRT was not associated with ESKD [subhazard ratio (HR) (95% confidence interval, CI) 1.00 (0.84-1.19),
Conclusion
UNASSIGNED
Oral IRT was associated with lower mortality only in patients with anemia. In patients without anemia, iron deficiency or CHF, the risk-benefit ratio of oral IRT should be further examined.
Identifiants
pubmed: 37915900
doi: 10.1093/ckj/sfad190
pii: sfad190
pmc: PMC10616436
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2082-2090Informations de copyright
Published by Oxford University Press on behalf of the ERA 2023.
Déclaration de conflit d'intérêts
C.P.K. has been a consultant for Abbott, Akebia, AstraZeneca, Bayer, Boehringer Ingelheim, Cara Therapeutics, CSL Vifor, CSL Behring, GSK, Pharmacosmos, ProKidney, Rockwell, Takeda and Tricida. C.M.R. has received honoraria from Ardelyx, AstraZeneca, Fresenius, Nutricia, Otsuka, Reata and Roche. K.K.-Z. has received honoraria and/or support from Abbott, Abbvie, ACI Clinical (Cara Therapeutics), Akebia, Alexion, Amgen, Ardelyx, ASN (American Society of Nephrology), AstraZeneca, Aveo, BBraun, Chugai, Cytokinetics, Daiichi, DaVita, Fresenius, Genentech, GSK, Haymarket Media, Hofstra Medical School, IFKF (International Federation of Kidney Foundations), ISH (International Society of Hemodialysis), International Society of Renal Nutrition & Metabolism (ISRNM), JSDT (Japanese Society of Dialysis Therapy), Hospira, Kabi, Keryx, Kissei, Novartis, Novo-Nordisk, OPKO, NIH (National Institutes of Health), NKF (National Kidney Foundations), Pfizer, Regulus, Relypsa, Resverlogix, Dr Schaer, Sandoz, Sanofi, Shire, VA (Veterans Affairs), Takeda, Vifor, UpToDate and ZS-Pharma. The other authors declared no conflicts of interest.
Références
Kidney Int Rep. 2019 Nov 13;5(2):121-134
pubmed: 32043026
Circulation. 1992 Sep;86(3):803-11
pubmed: 1516192
Clin J Am Soc Nephrol. 2009 Feb;4(2):435-41
pubmed: 19118116
Am J Nephrol. 2007;27(6):565-71
pubmed: 17804903
Front Pharmacol. 2014 Aug 27;5:195
pubmed: 25221512
Curr Opin Nephrol Hypertens. 2021 Jan;30(1):75-84
pubmed: 33148949
Eur J Clin Nutr. 2021 Mar;75(3):456-463
pubmed: 32901103
N Engl J Med. 2009 Dec 17;361(25):2436-48
pubmed: 19920054
Am J Kidney Dis. 2016 Nov;68(5):677-690
pubmed: 27321965
J Am Soc Nephrol. 2021 Aug;32(8):2020-2030
pubmed: 34244326
Toxins (Basel). 2020 Dec 11;12(12):
pubmed: 33322362
Nephron Clin Pract. 2005;100(3):c55-62
pubmed: 15824508
Ann Intern Med. 2020 Sep 15;173(6):426-435
pubmed: 32658569
J Clin Epidemiol. 1992 Jun;45(6):613-9
pubmed: 1607900
Nephrol Dial Transplant. 2003 May;18(5):924-30
pubmed: 12686666
Am J Physiol. 1984 Jun;246(6 Pt 1):E535-43
pubmed: 6742115
J Am Soc Nephrol. 2017 Apr;28(4):1248-1258
pubmed: 28122944
Epidemiology. 1994 Mar;5(2):243-6
pubmed: 8173000
J Am Soc Nephrol. 2015 Jun;26(6):1238-47
pubmed: 25542967
FEMS Microbiol Rev. 2014 Nov;38(6):1202-34
pubmed: 25205464
Eur J Heart Fail. 2022 Jan;24(1):192-204
pubmed: 34816550
Atherosclerosis. 2019 Feb;281:114-120
pubmed: 30658186
Am J Nephrol. 2006;26(5):445-54
pubmed: 17035697
Kidney Int. 2005 Dec;68(6):2846-56
pubmed: 16316362
Physiol Int. 2019 Sep 1;106(3):195-206
pubmed: 31560235
Am J Kidney Dis. 2008 Nov;52(5):897-906
pubmed: 18845368
Am J Epidemiol. 2019 Jan 1;188(1):250-257
pubmed: 30189042
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Kidney Int. 2021 Jun;99(6):1280-1295
pubmed: 33839163
JAMA. 2020 Jun 16;323(23):2417-2418
pubmed: 32369102
Kidney Int. 2019 Nov;96(5):1048-1050
pubmed: 31582227
JAMA Netw Open. 2022 Jun 1;5(6):e2215878
pubmed: 35657621
PLoS One. 2014 Jan 02;9(1):e84943
pubmed: 24392162
Nephrol Dial Transplant. 2001 May;16(5):967-74
pubmed: 11328902
Biochim Biophys Acta Mol Cell Biol Lipids. 2020 Feb;1865(2):158531
pubmed: 31666189
J Ren Care. 2009 Dec;35 Suppl 2:14-24
pubmed: 19891681
Am J Kidney Dis. 2016 Mar;67(3 Suppl 1):Svii, S1-305
pubmed: 26925525
Popul Health Metr. 2006 Apr 10;4:2
pubmed: 16606453
Eur J Heart Fail. 2016 Jul;18(7):774-85
pubmed: 27121474
Front Neurosci. 2019 Mar 15;13:165
pubmed: 30949015
Nephrol Dial Transplant. 2021 Jan 1;36(1):129-136
pubmed: 31641775
Clin J Am Soc Nephrol. 2016 May 6;11(5):821-831
pubmed: 27103623
Biomolecules. 2022 Nov 18;12(11):
pubmed: 36421722