Intravenous iron therapy and the cardiovascular system: risks and benefits

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dc.contributor.authorDel Vecchio, Lucia
dc.contributor.authorEkart, Robert
dc.contributor.authorCharles J. Ferro
dc.contributor.authorMalyszko, Jolanta
dc.contributor.authorMark, Patrick B.
dc.contributor.authorOrtiz, Alberto
dc.contributor.authorSarafidis, Pantelis
dc.contributor.authorValdivielso Revilla, José Manuel
dc.contributor.authorMallamaci, Francesca
dc.date.accessioned2022-03-21T08:46:49Z
dc.date.available2022-03-21T08:46:49Z
dc.date.issued2021
dc.description.abstractAnaemia is a common complication of chronic kidney disease (CKD). In this setting, iron deficiency is frequent because of the combination of increased iron needs to sustain erythropoiesis with increased iron losses. Over the years, evidence has accumulated on the involvement of iron in influencing pulmonary vascular resistance, endothelial function, atherosclerosis progression and infection risk. For decades, iron therapy has been the mainstay of therapy for renal anaemia together with erythropoiesis-stimulating agents (ESAs). Despite its long-standing use, grey areas still surround the use of iron therapy in CKD. In particular, the right balance between either iron repletion with adequate therapy and the avoidance of iron overload and its possible negative effects is still a matter of debate. This is particularly true in patients having functional iron deficiency. The recent Proactive IV Iron Therapy in Haemodialysis Patients trial supports the use of intravenous (IV) iron therapy until a ferritin upper limit of 700 ng/mL is reached in haemodialysis patients on ESA therapy, with short dialysis vintage and minimal signs of inflammation. IV iron therapy has also been proven to be effective in the setting of heart failure (HF), where it improves exercise capacity and quality of life and possibly reduces the risk of HF hospitalizations and cardiovascular deaths. In this review we discuss the risks of functional iron deficiency and the possible benefits and risks of iron therapy for the cardiovascular system in the light of old and new evidence.ca_ES
dc.description.sponsorshipA.O.’s research is supported by PI19/00588, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071, ISCIII-RETIC REDinREN RD016/0009 FEDER funds, Sociedad Española de Nefrología, Fundacion Renal Iñigo Álvarez de Toledo (FRIAT), Comunidad de Madrid CIFRA2 B2017/BMD-3686.ca_ES
dc.identifier.doihttps://doi.org/10.1093/ckj/sfaa212 
dc.identifier.issn2048-8505
dc.identifier.issn2048-8513
dc.identifier.urihttp://hdl.handle.net/10459.1/73334
dc.language.isoengca_ES
dc.publisherEuropean Renal Association - European Dialysis and Transplant Association (ERA-EDTA)ca_ES
dc.publisherOxford University Pressca_ES
dc.relation.isformatofReproducció del document publicat a: https://doi.org/10.1093/ckj/sfaa212 ca_ES
dc.relation.ispartofClinical Kidney Journal, 2021, vol. 14, núm. 4, p. 1067–1076ca_ES
dc.rightscc-by-nc (c)The Authors, 2021ca_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessca_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.subjectAnaemiaca_ES
dc.subjectCardiovascular diseaseca_ES
dc.subjectChronic kidney diseaseca_ES
dc.subjectFerritinca_ES
dc.subjectHeart failureca_ES
dc.subjectHaemodialysis, ironca_ES
dc.titleIntravenous iron therapy and the cardiovascular system: risks and benefitsca_ES
dc.typeinfo:eu-repo/semantics/articleca_ES
dc.type.versioninfo:eu-repo/semantics/publishedVersionca_ES
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