Related Experiment Video

Updated: Apr 9, 2026

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
04:53

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Published on: September 20, 2019

11.5K

A randomized trial of intravenous and oral iron in chronic kidney disease

Rajiv Agarwal1, John W Kusek2, Maria K Pappas1

  • 1Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA.

Kidney International
|June 18, 2015
PubMed

Insights

Intravenous iron therapy for chronic kidney disease patients with iron deficiency anemia showed similar kidney function decline but increased cardiovascular and infection risks compared to oral iron. This suggests caution with IV iron in non-dialyzed CKD patients.

Area of Science:

  • Nephrology
  • Hematology
  • Clinical Pharmacology

Background:

  • Iron deficiency anemia (IDA) is common in chronic kidney disease (CKD).
  • The impact of iron supplementation on kidney function in CKD patients remains unclear.
  • Oral and intravenous iron are treatment options for IDA in CKD.

Purpose of the Study:

  • To compare the effects of oral ferrous sulfate versus intravenous iron sucrose on kidney function in patients with stage 3-4 CKD and IDA.
  • To assess the safety profiles of oral versus intravenous iron in this patient population.

Main Methods:

  • Randomized trial comparing oral ferrous sulfate to intravenous iron sucrose in non-dialyzed patients with stage 3-4 CKD and IDA.
  • Primary outcome: difference in the slope of measured glomerular filtration rate (mGFR) change over two years.
  • Secondary outcomes: incidence of serious adverse events, including cardiovascular events and infections.

Main Results:

  • The trial was terminated early due to a low likelihood of detecting mGFR differences and a higher risk of adverse events with intravenous iron.
  • Measured glomerular filtration rate (mGFR) declined similarly in both groups over two years.
  • Intravenous iron was associated with a significantly higher risk of serious cardiovascular events (IRR 2.51) and infections requiring hospitalization (IRR 2.12).

Conclusions:

  • Among non-dialyzed patients with CKD and IDA, intravenous iron therapy is linked to an increased risk of serious adverse events.
  • Cardiovascular events and infections were more frequent in the intravenous iron group.
  • Oral iron may be a safer alternative for managing IDA in this patient population, warranting further investigation into optimal iron repletion strategies.

More Related Videos

The Caco-2 Cell Bioassay for Measurement of Food Iron Bioavailability06:34

The Caco-2 Cell Bioassay for Measurement of Food Iron Bioavailability

Published on: April 28, 2022

6.1K
Dynamic Light Scattering Analysis for the Determination of the Particle Size of Iron-Carbohydrate Complexes04:40

Dynamic Light Scattering Analysis for the Determination of the Particle Size of Iron-Carbohydrate Complexes

Published on: July 7, 2023

3.4K

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
513
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
643
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
640
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
1.2K
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
1.3K
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
1.0K