RT Journal Article
T1 Relationships between iron dose, hospitalizations and mortality in incident haemodialysis patients: a propensity-score matched approach.
A1 Varas, Javier
A1 Ramos, Rosa
A1 Aljama, Pedro
A1 Pérez-García, Rafael
A1 Moreso, Francesc
A1 Pinedo, Miguel
A1 Ignacio Merello, José
A1 Stuard, Stefano
A1 Canaud, Bernard
A1 Martín-Malo, Alejandro
A1 ORD Group, 
K1 anaemia
K1 haemodialysis
K1 hospitalization
K1 intravenous iron
K1 mortality
AB Intravenous iron management is common in the haemodialysis population. However, the safest dosing strategy remains uncertain, in terms of the risk of hospitalization and mortality. We aimed to determine the effects of cumulative monthly iron doses on mortality and hospitalization. This multicentre observational retrospective propensity-matched score study included 1679 incident haemodialysis patients. We measured baseline demographic variables, haemodialysis clinical parameters and laboratory analytical values. We compared outcomes among quartiles of cumulative iron dose (mg/kg/month). We implemented propensity-score matching (PSM) to reduce confounding due to indication. In the PSM cohort (330 patients), we compared outcomes between groups that received cumulative iron doses above and below 5.66 mg/kg/month. Kaplan-Meier analyses showed that the high iron dose group had significantly worse survival than the low iron dose group. A univariate analysis indicated that the monthly iron dose could significantly predict mortality. However, a multivariate regression did not confirm that finding. The multivariate regression analysis revealed that iron doses  >5.58 mg/kg/month were not associated with elevated mortality risk, but they were associated with elevated risks of all-cause and cardiovascular-related hospitalizations. These results were ratified in the PSM population. Intravenous iron administration is advisable for maintaining haemoglobin levels in patients that receive haemodialysis. Our data suggested that large monthly iron doses, adjusted for body weight, were associated with more hospitalizations, but not with mortality or infection-related hospitalizations.
YR 2018
FD 2018
LK http://hdl.handle.net/10668/11659
UL http://hdl.handle.net/10668/11659
LA en
DS RISalud
RD Apr 6, 2025