Does IV Iron Therapy Increase Mortality or Morbidity?
The relationship between IV iron use and mortality and morbidity in CKD has been examined only among dialysis-dependent patients. Judicious use of IV iron is not associated with increased mortality or hospitalization. Two teams of investigators, using large-scale databases from national dialysis providers, arrived at this conclusion independently and have either published their results (4) or reported them in abstract form (5). Their results support the safety and continued use of IV iron agents over a wide dosing range in hemodialysis patients, consistent with prevailing clinical practice guidelines. Why do results differ between prevalent and incident patients? The explanation seems to reside with the timeliness and reliability of comorbidity information. Mortality in dialysis-dependent CKD is highly associated with comorbidity (6 8). Thus, relating iron use to mortality requires adjusting results for patient comorbidity. Comorbidity information obtained before initiating dialysis li
