Intravenous vs Oral Iron Does Not Increase CKD Risk

Investigators compared the therapies in a large national cohort of patients with normal kidney function.

Intravenous (IV) vs oral iron therapy is not associated with a higher risk for new-onset chronic kidney disease (CKD) among individuals with normal kidney function and no proteinuria, investigators reported at the American Society of Nephrology’s Kidney Week 2022 conference in Orlando, Florida.

A team led by Csaba P. Kovesdy, MD, of the VA Memphis Medical Center and the University of Tennessee Health Science Center in Memphis, studied 94,931 new users of iron replacement therapy (91,945 on oral and 2986 on IV iron) from 2004 to 2018 in a national cohort of US veterans.

In a propensity score-matched cohort, 1029 patients received oral iron and 1043 received IV iron with an estimated glomerular filtration rate (eGFR, in mL/min/1.73 m2) of 60 or higher and urinary albumin creatinine ratio (UACR) less than 30 mg/g at baseline. Dr Kovesdy and colleagues examined the effect of oral and IV iron on the incidence of eGFR less than 60 and incident albuminuria (UACR above 30 mg/g).

The investigators observed 370 cases of incident eGFR less than 60 (58 events per 1000 person-years) and 251 cases of incident albuminuria (39 events per 1000 person-years) over a median follow-up of 1.8 years.

The event rate of incident eGFR less than 60 in the oral and IV iron groups was 54 and 64 per 1000 person-years, respectively; the event rate of incident UACR more than 30 mg/g was 38 and 40 per 1000 person-years, respectively. These between-group differences were not statistically significant. 


Shrestha P, Paul S, Sumida K, et al. Association of parenteral vs. oral iron therapy with incident CKD. Presented at: Kidney Week 2022; November 3-6, Orlando, Florida. Abstract TH-PO682.

This article originally appeared on Renal and Urology News