TY - JOUR
T1 - Iron deficiency and iron therapy in heart failure and chronic kidney disease
AU - Walther, Carl P.
AU - Triozzi, Jefferson L.
AU - Deswal, Anita
N1 - Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Purpose of reviewIron deficiency is common and associated with adverse outcomes in heart failure, regardless of anemia. Iron deficiency, absolute and functional, with and without anemia, is associated with adverse outcomes in chronic kidney disease (CKD). Heart failure and CKD frequently occur together. Intravenous iron therapy has been shown to reduce heart failure symptoms and improve physical function in heart failure with reduced ejection fraction with iron deficiency. In CKD, intravenous or oral iron therapy are often used for management of anemia, along with erythropoiesis stimulating agents, yet the risks and benefits of intravenous iron use is controversial. In this review, we survey available evidence and ongoing studies of iron deficiency and iron supplementation in heart failure, and integrate with recent evidence on effectiveness and safety of intravenous iron therapy in CKD.Recent findingsIntravenous iron therapy improves heart failure symptoms and physical function in heart failure with reduced ejection fraction and iron deficiency, regardless of anemia, and may reduce heart failure hospitalizations and cardiovascular mortality. Sustained intravenous iron therapy regardless of hemoglobin level in selected patients with end-stage kidney disease receiving hemodialysis improves outcomes, and does not appear to cause infectious complications.SummaryIron therapy has important effects in heart failure and CKD, and appears safe in the short term. Ongoing trials will provide additional important information.
AB - Purpose of reviewIron deficiency is common and associated with adverse outcomes in heart failure, regardless of anemia. Iron deficiency, absolute and functional, with and without anemia, is associated with adverse outcomes in chronic kidney disease (CKD). Heart failure and CKD frequently occur together. Intravenous iron therapy has been shown to reduce heart failure symptoms and improve physical function in heart failure with reduced ejection fraction with iron deficiency. In CKD, intravenous or oral iron therapy are often used for management of anemia, along with erythropoiesis stimulating agents, yet the risks and benefits of intravenous iron use is controversial. In this review, we survey available evidence and ongoing studies of iron deficiency and iron supplementation in heart failure, and integrate with recent evidence on effectiveness and safety of intravenous iron therapy in CKD.Recent findingsIntravenous iron therapy improves heart failure symptoms and physical function in heart failure with reduced ejection fraction and iron deficiency, regardless of anemia, and may reduce heart failure hospitalizations and cardiovascular mortality. Sustained intravenous iron therapy regardless of hemoglobin level in selected patients with end-stage kidney disease receiving hemodialysis improves outcomes, and does not appear to cause infectious complications.SummaryIron therapy has important effects in heart failure and CKD, and appears safe in the short term. Ongoing trials will provide additional important information.
UR - http://www.scopus.com/inward/record.url?scp=85089129361&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089129361&partnerID=8YFLogxK
U2 - 10.1097/MNH.0000000000000630
DO - 10.1097/MNH.0000000000000630
M3 - Review article
C2 - 32701598
AN - SCOPUS:85089129361
SN - 1062-4821
VL - 29
SP - 508
EP - 514
JO - Current opinion in nephrology and hypertension
JF - Current opinion in nephrology and hypertension
IS - 5
ER -