Skip to main content
Journal cover image

Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.

Publication ,  Journal Article
Tangri, N; Miskulin, DC; Zhou, J; Bandeen-Roche, K; Michels, WM; Ephraim, PL; McDermott, A; Crews, DC; Scialla, JJ; Sozio, SM; Shafi, T ...
Published in: Nephrol Dial Transplant
April 2015

BACKGROUND: Intravenous iron use in hemodialysis patients has greatly increased over the last decade, despite limited studies on the safety of iron. METHODS: We studied the association of receipt of intravenous iron with hospitalizations in an incident cohort of hemodialysis patients. We examined 9544 patients from Dialysis Clinic, Inc. (DCI). We ascertained intravenous iron use from DCI electronic medical record and USRDS data files, and hospitalizations through Medicare claims. We examined the association between iron exposure accumulated over 1-, 3- or 6-month time windows and incident hospitalizations in the follow-up period using marginal structural models accounting for time-dependent confounders. We performed sensitivity analyses including recurrent events models for multiple hospitalizations and models for combined outcome of hospitalization and death. RESULTS: There were 22 347 hospitalizations during a median follow-up of 23 months. Higher cumulative dose of intravenous iron was not associated with all-cause, cardiovascular or infectious hospitalizations [HR 0.97 (95% CI: 0.77-1.22) for all-cause hospitalizations comparing >2100 mg versus 0-900 mg of iron over 6 months]. Findings were similar in models examining the risk of hospitalizations in 1- and 3-month windows [HR 0.88 (95% CI: 0.79-0.99) and HR 0.88 (95% CI: 0.74-1.03), respectively] or the risk of combined outcome of hospitalization and death in the 6-month window [HR 0.98 (95% CI: 0.78-1.23)]. CONCLUSIONS: Higher cumulative dose of intravenous iron may not be associated with increased risk of hospitalizations in hemodialysis patients. While clinical trials are needed, employing higher iron doses to reduce erythropoiesis-stimulating agents does not appear to increase morbidity in routine clinical care.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Nephrol Dial Transplant

DOI

EISSN

1460-2385

Publication Date

April 2015

Volume

30

Issue

4

Start / End Page

667 / 675

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Risk Factors
  • Renal Dialysis
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
  • Iron Compounds
  • Humans
  • Hospitalization
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tangri, N., Miskulin, D. C., Zhou, J., Bandeen-Roche, K., Michels, W. M., Ephraim, P. L., … DEcIDE Network Patient Outcomes in End-Stage Renal Disease Study Investigators, . (2015). Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study. Nephrol Dial Transplant, 30(4), 667–675. https://doi.org/10.1093/ndt/gfu349
Tangri, Navdeep, Dana C. Miskulin, Jing Zhou, Karen Bandeen-Roche, Wieneke M. Michels, Patti L. Ephraim, Aidan McDermott, et al. “Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.Nephrol Dial Transplant 30, no. 4 (April 2015): 667–75. https://doi.org/10.1093/ndt/gfu349.
Tangri N, Miskulin DC, Zhou J, Bandeen-Roche K, Michels WM, Ephraim PL, et al. Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study. Nephrol Dial Transplant. 2015 Apr;30(4):667–75.
Tangri, Navdeep, et al. “Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.Nephrol Dial Transplant, vol. 30, no. 4, Apr. 2015, pp. 667–75. Pubmed, doi:10.1093/ndt/gfu349.
Tangri N, Miskulin DC, Zhou J, Bandeen-Roche K, Michels WM, Ephraim PL, McDermott A, Crews DC, Scialla JJ, Sozio SM, Shafi T, Jaar BG, Meyer K, Boulware LE, DEcIDE Network Patient Outcomes in End-Stage Renal Disease Study Investigators. Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study. Nephrol Dial Transplant. 2015 Apr;30(4):667–675.
Journal cover image

Published In

Nephrol Dial Transplant

DOI

EISSN

1460-2385

Publication Date

April 2015

Volume

30

Issue

4

Start / End Page

667 / 675

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Risk Factors
  • Renal Dialysis
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
  • Iron Compounds
  • Humans
  • Hospitalization
  • Female